Plasminogen activator inhibitor type 1 in diabetes and hypertension

Plasminogen activator inhibitor type 1 (PAI-1) is the primary inhibitor of tissue plasminogen activator and a crucial element of the endogenous fibrinolytic system. Elevated levels of PAI-1 appear to be associated with an increased incidence of myocardial infarction and increased cardiovascular risk. Strong associations between PAI-1 and hypertriglyceridemia, hyperinsulinemia, and hypertension suggest that part of the increase in cardiovascular risk seen in individuals with these conditions may be related to elevated levels of PAI-1. The increased cardiovascular risk seen in those with essential hypertension may relate to an independent interaction between the renin-angiotensin system and PAI-1. The extent to which PAI-1 explains the increased incidence of cardiovascular disease in diabetic and hypertensive patients, as well as the extent to which this incidence can be reduced, remains unclear.