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Central systolic blood pressure relates inversely to nitric oxide synthesis in young black adults: the African-PREDICT study

Journal of Human Hypertension volume 35, pages 985–993 (2021)Cite this article

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Abstract

Lower nitric oxide (NO) bioavailabilty associates with hypertension in patients and elderly populations. With hypertension known to develop earlier in black populations, we compared both plasma and urinary NO-related markers and their associations with central systolic blood pressure (cSBP) and arterial stiffness in healthy young black and white adults. We included healthy black and white men and women (n = 1110; 20–30 years) and measured cSBP and pulse wave velocity (PWV), along with both plasma and urinary arginine, homoarginine, asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), as well as urinary ornithine/citrulline, nitrite and nitrate. In addition, the urinary nitrate-to-nitrite ratio (UNOxR) was calculated. The black men and women had higher cSBP and higher plasma arginine and ADMA, but lower urinary nitrate and UNOxR (all p ≤ 0.003) than their white counterparts. In single and forward stepwise multiple regression analyses, we found an inverse association of cSBP (adj. R2 = 0.124; β = –0.134; p = 0.006) and plasma homoarginine in black men. Central SBP associated inversely with UNOxR in black women only (adj. R2 = 0.171; β = –0.130; p = 0.029). In the white women, cSBP associated positively with urinary ADMA (adj. R2 = 0.372; β = 0.162; p = 0.015). PWV associated inversely with plasma ADMA (adj. R2 = 0.253; β = –0.163; p = 0.024) in the white women only. The lower NO synthesis and the higher cSBP in our black cohort support the notion of a potential increased risk for future large artery stiffness and hypertension development in later life.

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Fig. 1: A comparison of NO related biomarkes stratefied by sex and ethnicity.

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Acknowledgements

The authors are grateful towards all individuals participating voluntarily in the African-PREDICT study. The dedication of the support and research staff as well as students at the Hypertension Research and Training Clinic at the North-West University (Potchefstroom campus) are also duly acknowledged.

Funding

Funding The African-PREDICT study: The research funded in this manuscript is part of an ongoing research project financially supported by the South African Medical Research Council (SAMRC) with funds from National Treasury under its Economic Competitiveness and Support Package; the South African Research Chairs Initiative (SARChI) of the Department of Science and Technology and National Research Foundation (NRF) of South Africa (GUN 86895); SAMRC with funds received from the South African National Department of Health, GlaxoSmithKline R&D (Africa Non-Communicable Disease Open Lab grant), the UK Medical Research Council and with funds from the UK Government’s Newton Fund; as well as corporate social investment grants from Pfizer (South Africa), Boehringer-Ingelheim (South Africa), Novartis (South Africa), the Medi Clinic Hospital Group (South Africa) and in kind contributions of Roche Diagnostics (South Africa). Any opinion, findings, and conclusions or recommendations expressed in this material are those of the authors, and therefore, the NRF does not accept any liability in this regard.

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Authors and Affiliations

  1. Hypertension in Africa Research Team (HART); North-West University, Potchefstroom, South Africa

    Ashleigh Craig, Catharina M. C. Mels, Aletta E. Schutte & Ruan Kruger

  2. MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom, South Africa

    Catharina M. C. Mels, Aletta E. Schutte & Ruan Kruger

  3. Institute of Toxicology, Core Unit Proteomics, Hannover Medical School, Hannover, Germany

    Dimitrios Tsikas

  4. Institute of Clinical Pharmacology and Toxicology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany

    Rainer H. Boeger & Edzard Schwedhelm

  5. Deutsches Zentrum fuer Herz-Kreislauf-Forschung E.V. (DZHK), Partner Site Hamburg/Kiel/Luebeck, Hamburg, Germany

    Edzard Schwedhelm

  6. School of Population Health, University of New South Wales; The George Institute for Global Health, Sydney, Australia

    Aletta E. Schutte

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  1. Ashleigh Craig
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Craig, A., M. C. Mels, C., Tsikas, D. et al. Central systolic blood pressure relates inversely to nitric oxide synthesis in young black adults: the African-PREDICT study. J Hum Hypertens 35, 985–993 (2021). https://doi.org/10.1038/s41371-020-00453-9

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