EVALUATION OF SERUM NITRIC OXIDE IN ESSENTIAL HYPERTENSION AND ITS CORRELATION WITH SEVERITY OF DISEASE
Objective: Hypertension is the most common cardiovascular disease and one of the most important public health concerns all over the world. Primary
or essential hypertension is the major form of arterial hypertension without any definitive cause. It results from increase vascular tone and resistance
which may be confined to the lower level of endothelial derived relaxing factor such as nitric oxide (NO). Hence, the objective of this study is to find
out whether any correlation exists between the concentrations of serum NO (nitrite) and essential hypertensive patients categorized according to the
Joint National Committee 7 classification.
Methods: We selected age- and sex-matched 24 healthy individuals as controls and 35 essential hypertensive patients as cases. Out of 35 cases, 24
were included in stage 1 and 11 in stage 2 of essential hypertension. We estimated serum NO levels in study groups basing on the principle of Griess
Results: We observed reduction in mean serum NO level in cases which was statistically highly significant as compared to controls (8.14Â±0.33 vs.
13.53Â±0.38 Âµmol/L, p<0.001) and also in stage 2 patients when compared with stage 1 patients (5.97Â±0.31 vs. 9.15Â±0.28 Âµmol/L, p<0.001). In
hypertensive patients, serum NO showed a highly significant inverse correlation to both systolic (r=âˆ’0.89, p<0.001) as well as diastolic (r=âˆ’0.64,
p<0.001) blood pressure.
Conclusion: Thus, we can conclude that lower level of serum NO can be an important causative factor in the progress of essential hypertension.
Keywords: Essential hypertension, Endothelial-derived relaxing factor, Nitric oxide, Joint National Committee 7.
Park K. Hypertension. In: Parkâ€™s Textbook of Preventive and Social
ed. Jabalpur, (India): Banarsidas Bhanot Publishers;
Kotchen TA. Hypertensive vascular disease. In: Kasper DL, Fauci AS,
Braunwald E, Hauser SL, Longo DL, Jameson JL, Loscalzo J,
editors. Harrisonâ€™s Principle of Internal Medicine. 19
ed., Vol. II.
New York, NY: Mc Graw Hill Companies; 2015. p. 1611-26.
Chobanian AV, Bakris GL, Black HR, Cushman WC, Green LA,
Izzo JL Jr, et al. Seventh report of the Joint National Committee on
prevention, detection, evaluation, and treatment of high blood pressure.
Victor RG. Arterial hypertension. In: Goldman L, Schafer AI, editors.
Goldman-Cecil Medicine. 25
ed. Philadelphia, PA: Elsvier Publication;
Carretero OA, Oparil S. Essential hypertension. Part I: Definition and
etiology. Circulation 2000;101(3):329-35.
Staessen JA, Wang J, Bianchi G, BirkenhÃ¤ger WH. Essential
hypertension. Lancet 2003;361(9369):1629-41.
Leiper J, Nandi M. The therapeutic potential of targeting endogenous
inhibitors of nitric oxide synthesis. Nat Rev Drug Discov
Candipan RC, Wang BY, Buitrago R, Tsao PS, Cooke JP. Regression or
progression. Dependency on vascular nitric oxide. Arterioscler Thromb
Vasc Biol 1996;16(1):44-50.
Kelm M. Nitric oxide metabolism and breakdown. Biochim Biophys
Oemar BS, Tschudi MR, Godoy N, Brovkovich V, Malinski T,
LÃ¼scher TF. Reduced endothelial nitric oxide synthase expression and
production in human atherosclerosis. Circulation 1998;97(25):2494-8.
Sibal L, Agarwal SC, Home PD, Boger RH. The role of asymmetric
dimethylarginine (ADMA) in endothelial dysfunction and
cardiovascular disease. Curr Cardiol Rev 2010;6(2):82-90.
Sena CM, Pereira AM, SeiÃ§a R. Endothelial dysfunction: A major
mediator of diabetic vascular disease. Biochim Biophys Acta
Bryan NS, Grisham MB. Methods to detect nitric oxide and its metabolites
in biological samples. Free Radic Biol Med 2007;43(5):645-57.
Ranasinghe P, Cooray DN, Jayawardena R, Katulanda P. The influence
of family history of hypertension on disease prevalence and associated
metabolic risk factors among Sri Lankan adults. BMC Public Health
Ruilope LM. The kidney as a sensor of cardiovascular risk in essential
hypertension. J Am Soc Nephrol 2002;13 Suppl 3:S165-8.
Ruilope LM, Lahera V, Rodicio JL, Romero JC. Participation of nitric
oxide in the regulation of renal function: Possible role in the genesis of
arterial hypertension. J Hypertens 1994;12(6):625-31.
Whelton PK, He J, Appel LJ, Cutler JA, Havas S, Kotchen TA, et al.
Primary prevention of hypertension: Clinical and public health advisory
from The National High Blood Pressure Education Program. JAMA
Eliot WJ, Bakris GL, Black HR. Hypertension: Epidemiology,
pathophysiology, diagnosis, and treatment. In: Fuster V, Alexander RW,
Hurst JW, Oâ€™Rourke RA, King SB III
, Nash IS, et al., editors. In:
Hurstâ€™s The Heart. 13
ed. USA: McGraw-Hill; 2011. p. 1549-80.
Tobian L. Dietary sodium chloride and potassium have effects on the
pathophysiology of hypertension in humans and animals. Am J Clin
Nutr 1997;65 2 Suppl:606S-11.
Levine BE, Weller JM, Remington RD. Serum sodium and potassium in
essential hypertension. Circulation 1961;24:29-33.
Hvarfner A, Bergstrom R, Morlin C, Wide L, Ljunghall S. Relationships
between calcium metabolic indices and blood pressure in patients
with essential hypertension as compared with a healthy population.
J Hypertens 1987;5(4):451-6.
Rees DD, Palmer RM, Moncada S. Role of endothelium-derived nitric
oxide in the regulation of blood pressure. Proc Natl Acad Sci U S A
Node K, Kitakaze M, Yoshikawa H, Kosaka H, Hori M. Reduced
plasma concentrations of nitrogen oxide in individuals with essential
hypertension. Hypertension 1997;30:405-8.
Arora S, Das N, Srivastava K. Nitric oxide and eNOS gene in essential
hypertension. Int J Collab Res Intern Med Public Health 2009;1(2):56-71.
Chandra M, Maurya DR, Kumar S, Basara H, Ghatak A, Tekwani BL,
et al. Reversible suppression of nitric oxide system in essential
hypertension. Indian J Clin Biochem 2003;18(2):150-3.
How to Cite
The publication is licensed under CC By and is open access. Copyright is with author and allowed to retain publishing rights without restrictions.