Effect of a combination of arterial hypertension and insulin resistance on hemostasis activity
Lasting existence of arterial hypertension in combination with insulin-resistance inevitably disturbs functioning of all the hemostasis elements. Weakening of vascular control over platelets' aggregation, hemocoagulation and fibrinolysis is noted in these conditions. Production lowering of substances with thrombo-resistant properties in vessels, increase of endothelium permeability for macromolecules, accumulation of lipoproteins in vascular wall, adhesion of platelets and leucocytes to it lie in the basis of it. Patients with arterial hypertension and insulin-resistance are characterized by platelets' activation leading to the increase of circulating platelets with changed surface structure in blood and their aggregates. In the given category of patients it is caused by the increased content of biologically active substances in platelets and number increase of different receptors on their surface, including fibrinogen. Combination of arterial hypertension with insulin-resistance inevitably disturbs functioning of coagulative component of hemostasis system - the content of fibrinogen, VII, VIII, IX factors of coagulation, von Willebrand's Factor increases in blood at activity lowering of antithrombin III, protein C and protein S. The complexity of hemostasiopathy in arterial hypertension and insulin resistance dictate the need to continue the search for therapeutic approaches which can balance thrombophilia and simultaneously affect all the components of the hemostatic system.