RELATIONSHIP BETWEEN HAEMOSTATIC PARAMETERS AND MICROALBUMINURIA AS PREDICTORS OF TARGET ORGAN DYSFUNCTION IN HYPERTENSIVES IN NORTHERN NIGERIA

Abstract

Introduction/background: Hypertension is one of the commonest non-communicable diseases in our environment and is of public health significance due to the medical and socioeconomic sequelae of its complications. These complications have been associated with abnormalities in haemostasis and rheology.
Aim and objectives: To determine some haemostatic parameters in hypertensive patients, some factors influencing them and their relationship with microalbuminuria as predictors of target organ damage.
Materials and methods: It was a cross-sectional, descriptive, non-interventional study, which utilized interviewer-administered questionnaires, physical examination and tests on urine and blood specimens. One hundred and seven (107) adult participants were studied. Full blood counts, biochemical and haemostatic tests were carried out.
Results: Majority of the participants were female n=91(85%) while 16(15%) were male. The mean ages of the female and male participants were 50.2±11.3 and 59.3±18.2 respectively. The modal age group was 40-65 years. Housewives formed 28% of the females and most of the participants fell into social class IV (44.9%). Alcohol ingestion and smoking were significant risk factors for the development of hypertension in males (OR=6.8/12.9; P=0.010/0.010 respectively). A positive family history of hypertension in a first and second degree relative was obtained in 91.7% and 8.3% of the participants.
Most of the participants had haematological and red cell indices within reference ranges but showed statistically significant differences between the sexes. The study population had 43%, 45.8% and 35.5% of values for PT, aPTT and TT within reference limits. Normal D-dimer levels were found in 74.8% of the participants but fibrinogen levels were universally low.
Haemostatic parameters showed no statistically significant difference between well and poorly controlled blood pressure (P>0.05) though subjects with poorly controlled blood pressure had a higher risk of having derangements in aPTT and platelet counts (OR=1.38/1.38; P=0.630/0.879)

Subjects on ARB/ACEI-containing regimens were 1.56 times more likely to have derangements in TT (P=0.377). Similar findings were seen for aPTT, PT and D-dimer levels but platelet counts had a 0.96 risk (P=0.836).
D-dimer levels showed a statistically significant trend with duration of hypertension up to 10 years. Platelet counts had a statistically significant relationship with TOD (P=0.039) and all the haemostatic parameters showed a weakly positive but statistically significant relationship with microalbuminuria (<0.0001) except D-dimers (P=0.218).
Conclusion: There is a high prevalence of hypertensive target organ damage among hypertensive patients in ABUTH, Zaria and haemostatic parameters may play a role in causation.