Comparative Analysis of Endothelial Status and Hemostatic Potential in Hypertensive Patients under Different Types of Drug Therapy

Abstract:: Hypertension is associated with hemostatic disorders and endothelial dysfunction. Un-derstanding hemostatic potential and endothelial function under antihypertensive pharmacotherapy can help personalize treatment and reduce the risk of thrombotic complications. Objective:: To conduct a comparative analysis of endothelial function and hemostatic potential in hypertensive patients receiving different types of pharmacological therapy. Methods:: This cross-sectional study included 185 patients diagnosed with hypertension. Partici-pants were divided into four groups based on their therapy regimen: Group 1—no therapy, Group 2—monotherapy, Group 3—two-drug therapy, and Group 4—three-drug therapy. Differences in hemostatic potential and endothelial function, assessed using piezothromboelastography and the Celermajer DS test, were analyzed using the Kruskal-Wallis and Mann-Whitney tests. Results:: Piezothromboelastography revealed a progressive increase in maximum clot density am-plitude (MA) from Group 1 to Group 4: 502 (437.75; 556.75) rel. units (Group 1), 525 (463; 572) rel. units (Group 2), 577 (536; 628) rel. units (Group 3), and 596 (504; 651) rel. units (Group 4) (p = 0.0001). The Celermajer DS test indicated the highest degree of endothelial dysfunction in Groups 3 and 4: 10.87 (7.14; 17.02) % and 7.84 (5; 9.76)% respectively (p = 0.006). Conclusion:: Despite achieving target blood pressure, patients on combination antihypertensive therapy exhibit a procoagulant state and persistent endothelial dysfunction. These findings may guide the use of antithrombotic or vasoprotective therapies to prevent thrombohemorrhagic com-plications.