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Abstract

Nitric oxide (NO) is implicated in the regulation of blood pressure (BP) and its reduction may result in arterial hypertension. The aim of the study was to evaluate circulating NO levels in patients with sustained hypertension (SH) and white coat hypertension (WCH). SH was defined as clinic BP ≥ 140/90 mmHg and daytime BP > 135/85 mmHg, and WCH was defined as clinic BP ≥ 140/90 mmHg and daytime BP < 135/85 mmHg. From subjects submitted to ambulatory BP monitoring (SpaceLabs 90207) we selected 18 patients with SH and 18 with WCH matched for age, gender and body mass index (BMI). Groups received a similar dietary pattern. Subjects with diabetes mellitus, hypercholesterolemia, obesity and smoking habit were excluded. Blood samples were drawn for routine laboratory tests and NO assay. Total nitrite was measured by using the Griess reagent after enzymatic conversion of all nitrate to nitrite (Oxis International, Inc.) and was used as an indicator of overall NO production.

Our data show that circulating NO levels are lower in SH than in WCH suggesting differences in NO pathway between these groups. Whether this aspect is primary or secondary to increased BP is unclear at present. In the former hypothesis, these findings suggest that SH and WCH show some differences in the pathophysiologic background. In the latter hypothesis, our data suggest that SH reduces NO availability more than WCH. (See Table)

SHWCH
M/W10/810/8
Age, yrs45±745±8
BMI, kg/m225.5±2.325.5±2.2
Clinic BP, mmHg153±8/99±4148±3/96.5±2.5*
Daytime BP, mmHg144±8/94±4128±5/79±4***
Nighttime BP, mmHg129±11/81±7112±6/68±7***
24-hour BP, mmHg139±7/90±5123±5/75±4***
Total No2-, micromol/L23.6±8.531.5±10.8**
SHWCH
M/W10/810/8
Age, yrs45±745±8
BMI, kg/m225.5±2.325.5±2.2
Clinic BP, mmHg153±8/99±4148±3/96.5±2.5*
Daytime BP, mmHg144±8/94±4128±5/79±4***
Nighttime BP, mmHg129±11/81±7112±6/68±7***
24-hour BP, mmHg139±7/90±5123±5/75±4***
Total No2-, micromol/L23.6±8.531.5±10.8**
*

P < 0.05;

**

P < 0.01;

***

P < 0.0001

SHWCH
M/W10/810/8
Age, yrs45±745±8
BMI, kg/m225.5±2.325.5±2.2
Clinic BP, mmHg153±8/99±4148±3/96.5±2.5*
Daytime BP, mmHg144±8/94±4128±5/79±4***
Nighttime BP, mmHg129±11/81±7112±6/68±7***
24-hour BP, mmHg139±7/90±5123±5/75±4***
Total No2-, micromol/L23.6±8.531.5±10.8**
SHWCH
M/W10/810/8
Age, yrs45±745±8
BMI, kg/m225.5±2.325.5±2.2
Clinic BP, mmHg153±8/99±4148±3/96.5±2.5*
Daytime BP, mmHg144±8/94±4128±5/79±4***
Nighttime BP, mmHg129±11/81±7112±6/68±7***
24-hour BP, mmHg139±7/90±5123±5/75±4***
Total No2-, micromol/L23.6±8.531.5±10.8**
*

P < 0.05;

**

P < 0.01;

***

P < 0.0001

Nitric oxide, Sustained hypertension, White coat hypertension
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© American Journal of Hypertension, Ltd. 2001
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