Hypertension in patients with polycythemia vera: Focus on microcirculation

Background. In oncohematology, microcirculatory disorders in patients with coexistent myeloproliferative diseases and arterial hypertension (HTN) are poorly understood.

The aim of study was to investigate changes in microcirculation in patients with polycythemia vera (PV) and HTN by laser Doppler flowmetry.

Design and methods. We examined 76 patients with PV, among them 49 patients had coexistent PV and HTN. Microcirculatory disorders were assessed by laser Doppler flowmetry. The survey was carried out by a standard procedure, which included three methods: laser Doppler flowmetry, optical tissue oximetry and pulse oximetry. The level of endothelin‑1 (ЕТ‑1) was determined by enzyme immunoassay.

bET‑1 level was higher (p < 0,05) in PV + HTN patients than in the control group (2,40 ± 0,49 and 1,52 ± 0,50 fmol/ml, respectively). The spastic type of microcirculation was found in PV patients. Correlation analysis demonstrated relationship of ET-1 level with the parameter I in patients with PV and HTN (r = 0,67, p = 0,025). The correlation between endothelin‑1 and the parameter I in patients with PV and HTN evidences that the indicator I is a diagnostic criterion of endothelial dysfunction in PV.

Conclusions. ET‑1 level and parameters of laser Doppler flowmetry reflect the PV-related change in the microvasculature, as well as concomitant HTN. Moreover, it also provides insights into the mechanism of these changes.

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