Introduction: Increased levels of prothrombotic markers such as fibrinogen and plasminogen activator-inhibitor-1 (PAI-1) have been related to target organ damage and cardiovascular outcomes in hypertensive population. Arterial stiffness is an important determinant of cardiovascular performance and a predictor of the corresponding risk. The association of fibrinogen and PAI-1 with arterial stiffness in hypertensive patients has not been defined.

Methods: We studied 285 consecutive, non-diabetic patients with uncomplicated, never treated essential hypertension (mean age 50 years, 184 males). Carotid-femoral and carotid-radial pulse wave velocity (PWVc-f and PWVc-r) were measured as indices of elastic-type, large-artery (aortic) stiffness and muscular type, medium-sized arterial stiffness respectively. Serum PAI-1 and plasma fibrinogen were measured in all participants.

Results: Across the tertiles of fibrinogen, we found a significant increase in PWVc-f (7.36 vs 7.52 vs 8.17m/s at tertiles 1 to 3, p < 0.001) but not in PWVc-r as well (8.73 vs 8.70 vs 8.68 m/s, p = NS). Across the tertiles of logPAI-1 was also a gradual increase in PWVc-f (7.43 vs 7.73 vs 7.93 m/s, p = 0.02) but no significant difference was observed in PWVc-r levels (8.57 vs 8.82 vs 8.74m/s, p = NS). In multivariate analysis, the association of fibrinogen with PWVc-f remained significant (β = 0.12, p < 0.05) after adjustment for age, gender, systolic blood pressure, smoking, body mass index, HbA1c and serum cholesterol. However, the associations of PAI-1 with PWVc-f disappeared once the above confounding factors were taken into account.

Conclusion: The present study shows that in hypertensive subjects increased aortic stiffness is related to increased plasma levels of fibrinogen. This finding may have important implications for hypertensive patients.