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      Evaluation of Mean Platelet Volume in Children with Hypertension

      research-article
      1 , , 2
      International Journal of Hypertension
      Hindawi

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          Abstract

          Background

          Childhood hypertension, a disease with increasing prevalence, can lead to severe health problems. With the increased pressure on the vascular endothelium in hypertension, lesions in the endothelium result in endothelial activation and a process of inflammation, which causes platelet activation and in the bone marrow the release of platelet precursor cells into the peripheral blood stream. During inflammation, changes in the number and size of platelets are observed. With the release of platelet precursors into the peripheral blood stream due to platelet activation, an increase in mean platelet volume (MPV) is also seen.

          Aim

          Our aim in this study is the evaluation of MPV changes in the hemogram of children suffering from hypertension, a condition causing severe cardiovascular problems. Material and Methods. This research is a descriptive retrospective cross-sectional study. It consists of a patient group diagnosed with hypertension and a control group of children presenting for routine check-ups with no diagnosed hypertension. Demographic characteristics, arterial pressure values, and hemogram parameters have been evaluated.

          Results

          A total of 90 cases were enrolled in the study, including a patient group of 45 cases with hypertension (19 females, 26 males) and a control group of 45 cases (27 females, 18 males). The median age was 15 years in the hypertension group and 13 years in the control group. In the hypertension cases, the thickness of the carotis intima media was statistically significantly greater than in the control group ( p < 0.001). Echocardiographic findings (IVSd, LVDd, LVPWd, IVSs, LVDs, LVPWs, and LV mass) were significantly higher in the hypertension group compared to the control group ( p < 0.001). A statistically significant difference in platelet count and MPV values between the groups was not found ( p = 0.151, p = 0.405, respectively).

          Conclusion

          While MPV is hypothesized to be higher in hypertensive individuals, there was no statistically significant difference between the hypertensive and non-hypertensive groups in this study.

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          Most cited references26

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          Mean Platelet Volume (MPV): New Perspectives for an Old Marker in the Course and Prognosis of Inflammatory Conditions

          Platelet size has been demonstrated to reflect platelet activity and seems to be a useful predictive and prognostic biomarker of cardiovascular events. It is associated with a variety of prothrombotic and proinflammatory diseases. The aim is a review of literature reports concerning changes in the mean platelet volume (MPV) and its possible role as a biomarker in inflammatory processes and neoplastic diseases. PubMed database was searched for sources using the following keywords: platelet activation, platelet count, mean platelet volume and: inflammation, cancer/tumor, cardiovascular diseases, myocardial infarction, diabetes, lupus disease, rheumatoid arthritis, tuberculosis, ulcerative colitis, renal disease, pulmonary disease, influencing factors, age, gender, genetic factors, oral contraceptives, smoking, lifestyle, methods, standardization, and hematological analyzer. Preference was given to the sources which were published within the past 20 years. Increased MPV was observed in cardiovascular diseases, cerebral stroke, respiratory diseases, chronic renal failure, intestine diseases, rheumatoid diseases, diabetes, and various cancers. Decreased MPV was noted in tuberculosis during disease exacerbation, ulcerative colitis, SLE in adult, and different neoplastic diseases. The study of MPV can provide important information on the course and prognosis in many inflammatory conditions. Therefore, from the clinical point of view, it would be interesting to establish an MPV cut-off value indicating the intensity of inflammatory process, presence of the disease, increased risk of disease development, increased risk of thrombotic complications, increased risk of death, and patient's response on applied treatment. Nevertheless, this aspect of MPV evaluation allowing its use in clinical practice is limited and requires further studies.
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            The role of platelets in inflammation.

            There is growing recognition of the critical role of platelets in inflammation and immune responses. Recent studies have indicated that antiplatelet medications may reduce mortality from infections and sepsis, which suggests possible clinical relevance of modifying platelet responses to inflammation. Platelets release numerous inflammatory mediators that have no known role in haemostasis. Many of these mediators modify leukocyte and endothelial responses to a range of different inflammatory stimuli. Additionally, platelets form aggregates with leukocytes and form bridges between leukocytes and endothelium, largely mediated by platelet P-selectin. Through their interactions with monocytes, neutrophils, lymphocytes and the endothelium, platelets are therefore important coordinators of inflammation and both innate and adaptive immune responses.
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              Roles of Inflammation, Oxidative Stress, and Vascular Dysfunction in Hypertension

              Hypertension is a complex condition and is the most common cardiovascular risk factor, contributing to widespread morbidity and mortality. Approximately 90% of hypertension cases are classified as essential hypertension, where the precise cause is unknown. Hypertension is associated with inflammation; however, whether inflammation is a cause or effect of hypertension is not well understood. The purpose of this review is to describe evidence from human and animal studies that inflammation leads to the development of hypertension, as well as the evidence for involvement of oxidative stress and endothelial dysfunction—both thought to be key steps in the development of hypertension. Other potential proinflammatory conditions that contribute to hypertension—such as activation of the sympathetic nervous system, aging, and elevated aldosterone—are also discussed. Finally, we consider the potential benefit of anti-inflammatory drugs and statins for antihypertensive therapy. The evidence reviewed suggests that inflammation can lead to the development of hypertension and that oxidative stress and endothelial dysfunction are involved in the inflammatory cascade. Aging and aldosterone may also both be involved in inflammation and hypertension. Hence, in the absence of serious side effects, anti-inflammatory drugs could potentially be used to treat hypertension in the future.
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                Author and article information

                Contributors
                Journal
                Int J Hypertens
                Int J Hypertens
                IJHY
                International Journal of Hypertension
                Hindawi
                2090-0384
                2090-0392
                2023
                21 September 2023
                : 2023
                : 5731260
                Affiliations
                1Department of Pediatrics, Faculty of Medicine, Yalova University, Yalova, Turkey
                2Division of Pediatric Cardiology, Department of Pediatrics, Faculty of Medicine, Tekirdağ Namık Kemal University, Tekirdağ, Turkey
                Author notes

                Academic Editor: Tomohiro Katsuya

                Author information
                https://orcid.org/0000-0003-3570-8394
                https://orcid.org/0000-0003-1587-7051
                Article
                10.1155/2023/5731260
                10539085
                37781274
                718d89f6-0849-442f-b0e0-1dcfd894f416
                Copyright © 2023 Ismail Yildiz and Ozgur Kizilca.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 17 April 2023
                : 1 September 2023
                : 13 September 2023
                Categories
                Research Article

                Cardiovascular Medicine
                Cardiovascular Medicine

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