Has antiplatelet therapy a role in the management of hypertension?

A. Zanchetti

Research output: Contribution to journalArticlepeer-review

Abstract

While the benefits of antiplatelet therapy are well established in secondary prevention of cardiovascular events, the role of antiplatelet therapy in primary prevention is still uncertain. There would be an undoubted interest, however, to know the effects that antiplatelet therapy may exert in patients with a definite cardiovascular risk factor such as hypertension. Indeed, antihypertensive therapy has been shown to exert an important and prompt beneficial effect on strokes, but it exerts a less conspicuous or less prompt effect in the prevention of coronary events. Although several explanations can be proposed to account for the different extent of the benefits of antihypertensive therapy on stroke and myocardial infarction, a definite possibility is that coronary events depend to a large extent upon thrombogenic mechanisms. In principle, antiplatelet activity obtained either by adding an antiplatelet agent to antihypertensive therapy or by using antihypertensive drugs with antiplatelet activity, may induce additional beneficial effects, in particular in the prevention of myocardial infarction. On the other hand, antiplatelet or antithrombotic actions may facilitate or aggravate hemorrhagic stroke, thus nullifying or detracting from the potential beneficial action on myocardial infarction. Little is known of the effects of the various classes of antihypertensive agents on thrombogenic mechanisms, although some data suggest the calcium antagonists may exert some antiplatelet action. A more direct way to approach the question whether interference with platelet activity may be beneficial in the treatment of hypertensive patients has been chosen in the large Hypertension Optimal Treatment (HOT) study, that has recruited as many as 19,000 hypertensive patients. One of the objectives of this study is to evaluate the effect of a low dose, 75 mg daily, of aspirin compared with placebo in the prevention of cardiovascular mortality and morbidity of hypertensive patients receiving concomitant antihypertensive therapy.

Original languageEnglish
Pages (from-to)388-391
Number of pages4
JournalOspedale Maggiore
Volume90
Issue number4
Publication statusPublished - 1996

Keywords

  • antihypertensive therapy
  • antiplatelet therapy
  • aspirin
  • hypertension
  • hypertension-related vascular lesions
  • myocardial infarction
  • primary cardiovascular prevention
  • stroke

ASJC Scopus subject areas

  • Medicine(all)

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