The relationship between plasminogen activator inhibitor-1 levels and blood pressure in adolescents with a history of prematurity and/or low birth weight.

BACKGROUND: Prematurity and low birth weight (LBW) are important early-life risk factors that contribute to an increased risk of cardiovascular diseases. Plasminogen activator inhibitor-1 (PAI-1) is a key regulator of the antifibrinolytic system and plays a critical role in vascular remodeling and arterial elasticity. The purpose of this study is to examine the relationship between PAI-1 levels and blood pressure in adolescents with a history of prematurity and/or LBW. METHODS: This observational analytical study was conducted at schools near the Prof. Dr. R.D. Kandou General Hospital, Manado, from July to December 2024, using a cross-sectional study design. The subjects were adolescents aged 13-18 years with a history of prematurity and/or LBW who met the inclusion criteria. Blood pressure was measured using a standardized sphygmomanometer, and PAI-1 levels were assessed through serum blood analysis. RESULTS: Fifty-two adolescents were included, with a median age of 174 months (IQR 156-215). PAI-1 levels were significantly higher in the group with abnormal blood pressure compared to the normal group (15.2 ± 3.3 vs. 7.2 ± 4.3 ng/mL; p < 0.001). In the hypertensive category, the mean PAI-1 was also higher compared to the normal or pre-hypertension group (p < 0.001). There was a moderate positive correlation between PAI-1 levels and systolic blood pressure (r = 0.503; p < 0.001) and diastolic blood pressure (r = 0.443; p = 0.001). CONCLUSION: PAI-1 levels are significantly associated with blood pressure in adolescents with a history of prematurity and/or LBW, supporting its role as a biomarker related to hemodynamic changes and as a screening tool for early vascular dysfunction in high-risk populations.