Mean platelet volume in patients with primary aldosteronism, role of antihypertensive drugs Ercan Varol ⁎, Mehmet Ozaydin Department of Cardiology, Faculty of Medicine, Suleyman Demirel Univesitesi Tip Fakultesi, Isparta, Turkey article info Article history: Received 16 May 2013 Accepted 30 June 2013 Available online 22 July 2013 Keywords: Mean platelet volume Primary aldosteronism Hypertension We read the article by Kurisu et al. with great interest [1]. They compared the platelet indices in patients with primary aldosteronism (PA) and in normotensive controls. They also assessed the relation of mean platelet volume (MPV) to left ventricular hypertrophy in patients with PA. This is an interesting and important study. However, we want to make minor criticisms about this study from a methodological aspect. There are significant associations of MPV with cardiovascular diseases, diabetes mellitus, prediabetes, hypertension, hypercholester- olemia, obesity, metabolic syndrome, statin and some antihypertensive use and atrial fibrillation [2]. These factors can influence the MPV values. Although the authors excluded some chronic diseases, they did not mention about the atrial fibrillation. Hypertension can induce paroxysmal and persistent atrial fibrillation. It has been shown that MPV is elevated in patients with paroxysmal atrial fibrillation [3]. The patients might be in sinus rhythm at the time of blood sampling. However, paroxysmal atrial fibrillation might be present in these patients that can only be determined by 24-h Holter monitoring. It is evident that hypertension can increase MPV [4]. We think that hypertension itself causes increased MPV independent of aldosterone. There are also no data about antihypertensive drugs used in patients with PA and in controls. It has been shown that some antihypertensive drugs can decrease MPV values [5,6]. The information about antihy- pertensive drugs used is lacking We believe that, it would be useful, if the authors provided data about these confounding factors on MPV. References [1] Kurisu S, Shimonaga T, Iwasaki T, et al. Mean platelet volume in patients with primary aldosteronism and its relation to left ventricular hypertrophy. Int J Cardiol 2013;168(3):3143–4. [2] Vizioli L, Muscari S, Muscari A. The relationship of mean platelet volume with the risk and prognosis of cardiovascular diseases. Int J Clin Pract 2009;63(10):1509–15. [3] Colkesen Y, Acil T, Abayli B, et al. Mean platelet volume is elevated during paroxysmal atrial fibrillation: a marker of increased platelet activation? Blood Coagul Fibrinolysis Jul 2008;19(5):411–4. [4] Varol E, Akcay S, Icli A, et al. Mean platelet volume in patients with prehypertension and hypertension. Clin Hemorheol Microcirc 2010;45(1):67–72. [5] Nadar S, Blann AD, Lip GY. Platelet morphology and plasma indices of platelet activation in essential hypertension: effects of amlodipine-based antihypertensive therapy. Ann Med 2004;36(7):552–7. [6] Celik T, Yuksel UC, Iyisoy A, et al. Effects of nebivolol on platelet activation in hypertensive patients: a comparative study with metoprolol. Int J Cardiol Mar 20 2007;116(2):206–11. 0167-5273/$ – see front matter © 2013 Elsevier Ireland Ltd. All rights reserved. http://dx.doi.org/10.1016/j.ijcard.2013.06.116 ⁎ Corresponding author. Tel.: +90 5323468258; fax: +90 2462324510. E-mail address: drercanvarol@yahoo.com (E. Varol). 4505 Letters to the Editor