Structure and function of large arteries in hypertension in relation to oxidative stress markers.
BACKGROUND
The relationship between hypertension and oxidative stress remains unexplained. Nevertheless, it is well established that reactive oxygen species have an influence on the arterial wall, endothelial function and therefore determine blood pressure.


OBJECTIVE
The evaluation of selected oxidative stress markers in hypertensive patients and an assessment of the relationship between oxidative stress markers and the arterial structure and function. We also aimed to investigate whether the influence of oxidative stress on remodelling of arteries, their structural and functional changes is independent of hypertension or is related to hypertension.


METHODS
Altogether 217 subjects (114 female, 103 male) were enrolled from hypertensive families. The mean age was 45.5 ± 16 years, and the group included 155 hypertensives. In every subject, the pulse wave velocity and intima-media thickness (IMT) in carotid arteries were measured as well as selected oxidative stress markers such as asymmetric dimethylarginin (ADMA), symmetric dimethylarginin (SDMA), advanced oxidation protein products (AOPP) and oxidised low density lipoproteins (ox-LDL).


RESULTS
The results of multivariate analysis show that in hypertensive patients: the ADMA level increased with increasing peripheral pulse pressure (b = 0.003; p < 0.001), and AOPP was related to higher carotid IMT (b = 0.91; p = 0.036). In normotensive subjects, the following associations were found: between ADMA and central pulse pressure (b = 0.006; p = 0.008), between SDMA and the peripheral augmentation index (b = -0.03; p = 0.014), between AOPP and the peripheral augmentation index (b = 0.011; p = 0.04), and between ox-LDL/LDL ratio and the peripheral augmentation index (b = -0.025; p = 0.004). The SDMA/ADMA ratio was associated with estimated glomerular filtration rate in both groups (b = -0.0061; p < 0.0001 and b = -0.005; p < 0.017, respectively). In hypertensives, we observed a relation with peripheral pulse pressure (b = -0.0067; p = 0.0143). Moreover, in normotensives there was an association between the SDMA/ADMA ratio and uric acid (b = 1.3629; p = 0.046).


CONCLUSIONS
We found that the influence of oxidative stress on the structure and function of large arteries was independent of hypertension. Therefore oxidative stress may play a significant role in the development of arterial stiffness. Higher oxidative stress is associated with more advanced arterial remodelling in hypertension.
1st Department of Cardiology and Hypertension, Jagiellonian University Medical College, Krakow, Poland. lklima@su.krakow.pl.
Łukasz
Ł
Klima
Kalina
K
Kawecka-Jaszcz
Katarzyna
K
Stolarz-Skrzypek
Jan
J
Menne
Kamil
K
Fijorek
Agnieszka
A
Olszanecka
Wiktoria
W
Wojciechowska
Grzegorz
G
Bilo
Danuta
D
Czarnecka
D000328:Adult; D062107:Advanced Oxidation Protein Products / Q000097:blood; D001120:Arginine / Q000031:analogs & derivatives / Q000097:blood; D001158:Arteries / Q000000981:diagnostic imaging; D015415:Biomarkers / Q000097:blood; D002339:Carotid Arteries / Q000000981:diagnostic imaging*; D059168:Carotid Intima-Media Thickness; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018384:Oxidative Stress / Q000502:physiology*; D063177:Pulse Wave Analysis; D059289:Vascular Stiffness / Q000502:physiology*
D062107:Advanced Oxidation Protein Products; D015415:Biomarkers; D008077:Lipoproteins, LDL; C018524:N,N-dimethylarginine; D001120:Arginine