Abstract 16042: Plasminogen Activator Inhibitor-1 Predicts the Risk of Hypertension in American Indians: Findings From the Strong Heart Study
Background: Plasminogen activator inhibitor 1 (PAI-1) deficiency prevents hypertension and vascular fibrosis in animal models. A higher level of plasma PAI-1 was associated with hypertension in cross-sectional studies, but the prospective association of plasma PAI-1 with incident hypertension in large-scale community-based population is scarce.
Methods: Leveraging two longitudinal cohorts of American Indians in the Strong Heart Study (SHS, N = 1190, median 4.0-year follow-up) and the Strong Heart Family Study (SHFS, N = 1767, median 5.3-year follow-up), we examined the prospective association of plasma PAI-1 with incident hypertension. All participants were free of hypertension, CVD, and chronic kidney disease at baseline. Incident hypertension was defined as having a blood pressure ≥ 140/90 mmHg at the end of follow-up or initiating antihypertensive medications during follow-up. Plasma PAI-1 level at baseline was measured by immunoassay. The prospective association between PAI-1 and incident hypertension was examined by Cox proportional hazards model, adjusting for age, sex, site, smoking, drinking, obesity, triglycerides, fasting glucose, kidney function, and inflammation at baseline. Family relatedness in the SHFS was accounted for using the frailty model in Cox regression.
Results: A total of 305 and 280 participants, respectively, from the SHS (56 ± 7 years) and the SHFS participants (34 ± 14 years) developed incident hypertension during follow-up. In the SHS, a higher plasma level of PAI-1 was significantly associated with an increased risk of incident hypertension (HR [95%CI]: 1.36 [1.11-1.65]). Compared with participants in the lowest tertile of PAI-1 (<33 ng/mL), those in the highest tertile (≥ 58 ng/mL) had nearly 60% increased risk for the onset of hypertension (HR = 1.59 [1.15-2.19]). This association was confirmed in the SHFS (HR = 1.28 [1.06-1.56] for continuous PAI-1; HR = 1.48 [1.04-2.11] for highest vs. lowest PAI-1 levels).
Conclusion: A higher level of plasma PAI-1 significantly predicts the risk of hypertension in American Indians, independent of known risk factors. The prognostic value of plasma PAI-1 in predicting risk of hypertension needs further investigation.
Author Disclosures: H. Peng: None. F. Yeh: None. Y. Zhang: None. G. Simone: None. L. Best: None. E. Lee: None. B. Howard: None. J. Zhao: None.
- © 2016 by American Heart Association, Inc.