Evaluation of Platelet and Prothrombin Time in Hypertensive Patients Attending Clinic in Federal Teaching Hospital Abakaliki
Nwovu AI1, Obeagu Emmanuel Ifeanyi2*, Obeagu Getrude Uzoma3 and Nnadiekwe Onyinye Irene1
1Department of Medical Laboratory Science, Ebonyi State University, Nigeria
2Department of Health Services, Diagnostic Laboratory Unit, Michael Okpara University of Agriculture, Umudike, Nigeria
3Department of Nursing Science, Ebonyi State University, Abakaliki
Submission: December 19, 2017; Published: January 23, 2018
*Corresponding author: Obeagu Emmanuel Ifeanyi, Diagnostic Laboratory Unit, Department of Health Services, Michael Okpara University of Agriculture, Umudike, Abia State, Nigeria, Tel: +2348037369912; Email: emmanuelobeagu@yahoo.com
How to cite this article: Nwovu AI, Obeagu Emmanuel Ifeanyi, Obeagu Getrude Uzoma, Nnadiekwe Onyinye Irene. Evaluation of Platelet and Prothrombin Time in Hypertensive Patients Attending Clinic in Federal Teaching Hospital Abakaliki. Open Acc Blood Res Transfus J. 2018; 1(5): 555571. DOI: 10.19080/OABTJ.2018.01.555571
Abstract
The aim of this research work is to evaluate the platelet and prothrombin time test in hypertensive patient attending clinic in Federal Teaching Hospital, Abakaliki. A total of 80 subjects comprising of 40 males and 40 females between the ages of 30-70 years were selected for the study. Sixty (60) of the subjects (30 males and 30 females) were hypertensive patients while 20 of the subjects were apparently healthy nonhypertensive patients and were the control (10 males and 10 females). The method used for platelet count is the standard manual method using improved neubauer ruled counting chamber and prothrombin time method is plasmascann (ISI 1.4-1.6) with water bath at 37°c. The results for platelet count was P>0.05, r = +0.06, P=0.1290 and that of prothrombin time P>0.05, r =+0.006, P=0.0130. The mean age of the patients and control is 36.33±11.992 and 36.533±11.420 (years) respectively. In conclusion the result obtained indicates that there is no statistical significant difference (P>0.05) of prothrombin time and platelet count. It serves as indices for evaluating haemostatic abnormalities in hypertensive patients.
Keywords: Platelet; Prothrombin time; Hypertensive patients; Federal teaching hospital abakaliki
Introduction
A hypertensive patient is defined as patient with disorder in his/her blood pressure which occurs when the mean arterial pressure is greater than the upper range of accepted normality [1]. Hypertensive patients are at high risk for the development of cardiovascular diseases. High blood pressure is said to be present if it is often at or above 140/90mmHg [2].
A prothrombin time (PT) test, measures the amount of time it takes for your blood plasma to clot and in order to help diagnose unexplained bleeding and it helps to evaluate the extrinsic and common pathways of the coagulation cascade. Prothrombin, also known as factor II, is just one of many plasma proteins involved in the clothing process [3].
Platelets play a central role in maintaining hemostasis and must be present in adequate number and have normal function. Platelets undergo a complex series of morphological and biochemical changes when activated. Platelets have the ability to bind to non-endothelial surfaces (adhesion), bind to other platelets (aggregation) and secrete substances that are stored in internal granules (secretion) [4].
The normal haemostatic response to vascular damage depends on a closely linked interaction between the blood vessel wall, circulating platelets and blood coagulation factors.Pulmonary thrombosis often appears to complicate the course of patients with hypertension.
Thrombosis could be the consequence of a prothrombotic condition occurring in these patients with vascular and alveolar lesions or because of platelet dysfunction leading to pulmonary hypertension and pulmonary thrombolism [5].
Aim
The aim of this study is to evaluate the platelet and prothrombin time profile in hypertensive patients.
Materials and Methods
Study area
The study was carried out in Federal Teaching Hospital, Abakaliki, Ebonyi State, Nigeria. This research work was done in federal teaching hospital Abakaliki mainly in their major outpatient clinic (MOPC) and was carried out at federal teaching hospital Abakaliki (FETHA 2).
Study subjects
A total of 80 subjects comprise of 40 males and 40 females between the ages of 30-70 years were selected for this study. Out of which 60 (30 males and 30 females) were hypertensive patients while 20 (10 males and 10 females) were apparently healthy non-hypertensive patients.
Sample collection
7ml of blood was collected from each subject using the standard procedure. Out of which 4.5ml and 2.5ml was dispensed into a plain sterile container containing tri-sodium citrate fluid and EDTA containers respectively.
Prothrombin time
Method: Prothrombin time estimation by plasmascann using calcium thromboplastin (ISI 1.4-1.6).
Procedure
o The plasmascanvail was rehydrated and mixed gently with 2ml of distilled water and allowed for 10 minutes for homogenization of the reagent
o The reagent was incubated in a water bath at 37°C for 10 minutes
o The various blood collected was centrifuged at 3000g for 10 minutes to obtain platelet poor plasma.
o 0.lml (100ml of the plasma was) dispensed into a prewarmed glass tube and incubated in a water bath at 37 °C for 3 minute.
o 0.2ml (200ml) of the pre-warmed rehydrated plasmascann reagent was the dispensed into the glass tube containing the pre-warmed plasma 37 °C.
o The stop watch was started immediately and the time it takes the plasma to from clot (quick's time) was noted.
Platelet count
Method: manual method using improved neubauer ruled counting chamber
Procedure: The diluents consist of 1% aqueous ammonium oxalate in which the red cells are lyses.
o Measure 0.38ml of filtered ammonium oxidation diluting fluid and dispense it into a small container or tube
o Add 20uL (0.02ml, 20cm) of well- mixed anti coagulated venous blood and mix it together
o Assemble the counting chamber and full it with well- mixed sample.
o Leave the chamber undisturbed for 20 minutes
o Dry the underside of the chamber and place it on the microscope stage, using 40X objective to focus the ruling of the grid and the central square. Change to the 40X objective and focus platelets
Results (Table 1-3)
PT: Prothrombin time
Parameters P-value r-value
PT: Prothrombin Time; P-value: Probability value at 0.05 level of significance; r-value: Correlation Coefficient
Discussion
There has been considerable alarm at the recent increase in the incidence of hypertension all over the world [7]. Cytokines (e.g. interleukin-6 (IL-6) has been known to play a role in platelet production [8]. This study was therefore carried out to determine the impact of hypertension on some coagulation factors and also to determine the effects of hypertension on some coagulation factors (Prothrombin Time and Platelet Count).
The platelet count results was P>0.05, r = +0.06, P=0.1290 and that of prothrombin time result was P>0.05, r =+0.006, P=0.0130. The mean value of the age of the patient and control group was 36.33+11.99 and 36.53+11.42 respectively. There was an increase in the platelet count and prothrombin time of the patient compared to that of the control group. Analysis of the mean values of the patients PT and platelet count with respect to gender showed that the PT and platelet count of the male patient were higher than that of the female patients and in age also. The result of correlation of the coagulation factors showed a weak but non-significant positive correlation between PT and platelet count of the patient (p>0.05). Increased prothrombin time reported in this study has been reported elsewhere among patients with hypertension according to Kartaloglu et al. [9]. Prolonged prothrombin time and platelet count were common with patients with the age of 65 years and above, one could say that the phenomenon is due to diminished prostacyclin synthesis and/or release by the endothelial cells during old age. They also stated that cytokines and mediators emerging from a hypertensive patient are considered to prolong the PT. There is increased platelet production amongst the patient when compared with the control group. Reports elsewhere has shown that cytokines are increased in inflammatory reactions and also, these cytokines (mainly IL-6) increases platelet production [7,8].
Conclusion
In conclusion, the research on prothrombin time and platelet count was carried out on hypertensive patients. Due to the fact that there was significant increase in prothrombin time and platelet count of hypertensive patients when compared with non-hypertensive patients (control), the assessment of this parameters may serve as prognostic indices for evaluating hypertensive patients in whom there was clinical evidence of hemostatic abnormality and guide for antihypertensive therapy. This analysis, in conjunction with clinical findings, will shed light to the subject. It is recommended to conduct D-dimer, Activated partial thromboplastin time (APTT) and Protein assays.
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