Key result
Nitric oxide synthesis markers show no association with ambulatory blood pressure or arterial stiffness.
Why the study?
NO synthesis markers may be important in regulating vascular tone and arterial hypertension, but data regarding their association with blood pressure and vascular parameters are sparse and controversial.
Are NO synthesis markers associated with blood pressure and pulse wave velocity in adults with arterial hypertension?
Cross-Sectional (n=509)
No
Are NO synthesis markers associated with blood pressure and pulse wave velocity in adults with arterial hypertension?
Effect estimate: r = 0.1
p-value: p=0.43
NO synthesis markers are not significantly associated with blood pressure or pulse wave velocity in hypertensive adults, suggesting their link to adverse outcomes is not mediated by hypertension or endothelial dysfunction.
No support for incorporating NO markers into hypertension evaluation; leaves open their prognostic role via non-BP pathways.
Nitric oxide (NO) synthesis markers, comprising L-homoarginine, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA), are significantly associated with cardiovascular events and mortality. Being involved in NO pathways, they may be of high importance regulating vascular tone and arterial hypertension, but data on this topic are sparse and controversial. In this study, we evaluated whether these NO synthesis markers are associated with blood pressure values and pulse wave velocity (PWV). This analysis was based on the data of the Styrian Vitamin D Hypertension Trial, which included adults with arterial hypertension. We analyzed correlations of NO synthesis markers with 24 h ambulatory blood pressure values and PWV (primary outcomes), as well as with anthropometric and laboratory data. A total of 509 patients were included in the present analysis. The mean age was 61.2 ± 10.5 years, mean PWV was 8.6 ± 2.4 m/s, mean 24 h systolic blood pressure was 127.5 ± 13.8 mmHg and mean 24 h diastolic blood pressure was 76.4 ± 9.5 mmHg. In bivariate analyses, there was a significant positive correlation between homoarginine and 24 h diastolic blood pressure (r = 0.1; p = 0.02), which was revealed to be no longer significant after adjustment for age, gender and glomerular filtration rate (GFR) in multivariate regression analysis. No other significant correlations of any NO synthesis markers with blood pressure or PWV were observed. In line with previous studies, there were inverse associations between homoarginine and age and between ADMA or SDMA and GFR (p < 0.05 for all). This study did not reveal a significant association between homoarginine, ADMA or SDMA and blood pressure or PWV in hypertensive adults. These results suggested that the associations of these parameters with adverse outcome may not be mediated by hypertension and/or endothelial dysfunction.
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Malle et al. (2020) conducted a cross-sectional in Arterial hypertension (n=509). Nitric oxide (NO) synthesis markers (homoarginine, ADMA, SDMA) was evaluated on Correlation of NO synthesis markers with 24-hour ambulatory blood pressure values and pulse wave velocity (PWV) (r = 0.1, p=0.43). Serum levels of nitric oxide synthesis markers (homoarginine, ADMA, and SDMA) were not significantly associated with 24-hour ambulatory blood pressure or pulse wave velocity after adjustment for confounders.
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