V.A. Bobrov, I.G. Firsova Nitric oxide metabolism and endothelium dysfunction in patients with essential hypertension with signs of left ventricular remodeling

The blood levels of NO and it metabolites were determined in essential hypertension (EH) pts depending on clinical features of the disease and endothelium-dependent vasodilatation. 67 pts (46 men and 21 women) with
mild and moderate hypertension, middle age of (53.43±4.96) years and EH anamnesis of (6.93±2.40) years were observed. No clinical signs of ischemic heart disease or other diseases, requiring drug treatment, were
revealed. All pts underwent physical examination, standard clinical investigation, 24-h ambulatory blood pressure (BP) monitoring, echocardiography, determination of blood NO stable metabolites. All pts demonstrated increase of blood general NO, nitrit- and nitrate-anions accordingly by 56; 39 and 68 %, that directly correlated with left ventricular mass index and general carotid intima-media thickness and in inverse ratio – with
office diastolic BP and peripheral resistance. There was a reliable increase of blood NO metabolites levels due to nitrite-anionic complex in EH pts with damaged endothelium-dependent vasodilatation. The EH pts with “nondipper” and “over-dipper” 24-h BP monitoring type demonstrated more expressed left ventricular hypertrophy with tendency to the NO metabolites level increase due to a nitrite-anion compared to a “dipper” type. Pts with considerable, more than 35 mcmol/l of blood NO metabolites level demonstrated reliable increase of left ventricular volumes and tendency to worsening of diastolic function.

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