Advances in Research

Background: Hypertension is a common and important major global health problem affecting more than 927 million people worldwide. Elevated levels of P selectin correlates with platelet activation. Platelet activation plays a key role in the complications of hypertension.

Aim: To determine the serum levels of P selectin in hypertensive patients and to compare the serum P selectin in control subjects in North central Nigeria.

Methods: This is a cross-sectional comparative study conducted among 151 Hypertensives and 150 Normotensive controls in Federal Medical Centre Keffi Nasarawa State (North Central Nigeria). Soluble P-selectin levels were assessed using the enzyme-linked immunosorbent assay technique. Five millilitres (5mls) of venous blood were aseptically collected by venepuncture from each participant into plain tube and analysed using Elabsceince ELISA kits. Sample sized was determined using the Using the Leslie and Kish formula for sample size determination and a simple random sampling method was used to recruit participants. Differences between groups was assessed by the Mann Whitney U and Wilcoxon signed ranked test for nonparametric variables as appropriate. Pearson’s correlation coefficients were calculated to evaluate the association between relevant parameters. Data obtained were analysed using SPSS version 27, and results considered to be significant at p<0.05.

Results: P-selectin values observed in hypertensive cases were higher (median 6.7ng/ml) than that in normotensive individuals (median 4.245ng/ml) mm statistically significant difference (p=0.0001, P<0.05). There was also a statistically significant difference in P-selectin values between poorly controlled hypertensives (median 7.028ng/ml), well controlled hypertensives (median 5.983ng/ml) and normotensive controls (median 4.245ng/ml) (p<0.05). A cut off point for P-selectin value showing increased platelet activation for this study was derived using area under curve (AUC) and receiver operating characteristic (ROC). A value of 4.7ng/ml with 82% sensitivity and 74% specificity with an AUC of 0.78 was obtained.

Conclusion: This study found significantly higher levels of soluble P-selectin in hypertensive cases compared to normotensive controls. Patients with poorly controlled hypertension exhibited significantly elevated levels of soluble P-selectin compared with those whose blood pressure was well controlled. The increased P-selectin concentrations observed in hypertensive individuals suggest enhanced platelet activation associated with hypertension. Consequently, P-selectin may serve as a reliable marker of platelet activation in this context, with potential utility in identifying hypertensive patients at elevated cardiovascular risk.