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Nitric oxide synthesis capacity, ambulatory blood pressure and end organ damage in a black and white population: the SABPA study

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Abstract

Nitric oxide (NO) synthesis capacity is determined by the availability of substrate(s) such as l-arginine and the influence of nitric oxide synthase (NOS) inhibitors, asymmetric dimethylarginine (ADMA) and symmetric dimethylarginine (SDMA). These factors may be important in black South Africans with a very high prevalence of hypertension. We compared ambulatory blood pressure (BP), markers of end organ damage and NO synthesis capacity markers [l-arginine, l-homoarginine, l-citrulline, l-arginine:ADMA, ADMA, SDMA and dimethylarginine (DMA)], between black and white teachers (n = 390). Associations of nighttime BP and markers of end organ damage with NO synthesis capacity markers were also investigated. Although black men and women had higher BP and albumin-to-creatinine ratio (ACR) (all p < 0.001), they also had higher l-arginine, l-homoarginine, l-arginine:ADMA and lower SDMA and DMA levels (all p < 0.05). Only in white men ADMA concentrations associated positively with nighttime systolic blood pressure (R 2 = 0.20, β = 0.26, p = 0.009), nighttime diastolic blood pressure (R 2 = 0.23, β = 0.27, p = 0.007), carotid intima media thickness (cIMT) (R 2 = 0.36, β = 0.22, p = 0.008) and ACR (R 2 = 0.14, β = 0.32, p = 0.001). Our findings suggest that despite an adverse cardiovascular profile in blacks, their NO synthesis capacity profile seems favourable, and that other factors, such as NO inactivation, may prove to be more important.

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Acknowledgments

The Sympathetic activity and Ambulatory Blood Pressure in Africans (SABPA) study was possible due to the voluntary participation of the teachers and the Department of Education, North-West Province, South Africa. The authors thank and acknowledge the technical assistance of Mariola Kastner, Anna Steenpass, Mrs. Tina Scholtz, Sr. Chrissie Lessing and Dr. Szabolcs Péter. Research included in the present study was partially funded by the National Research Foundation (South Africa); the Medical Research Council (South Africa); Roche Diagnostics (South Africa); the North-West University (South Africa); and the Metabolic Syndrome Institute, France. Dr Atzler acknowledges the support of the European Union under a Marie Curie Intra-European Fellowship for Career Development.

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Authors and Affiliations

  1. Hypertension in Africa Research Team (HART), North West University, Private Bag x6001, Potchefstroom, 2520, South Africa

    Catharina M. C. Mels, Ilisma Loots & Aletta E. Schutte

  2. Department of Clinical Pharmacology and Toxicology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany

    Edzard Schwedhelm, Dorothee Atzler & Rainer H. Böger

  3. Radcliffe Department of Medicine, University of Oxford, Oxford, UK

    Dorothee Atzler

  4. MRC Research Unit for Hypertension and Cardiovascular Disease, North-West University, Private bag X6001, Potchefstroom, 2522, South Africa

    Aletta E. Schutte

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  1. Catharina M. C. Mels
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  3. Edzard Schwedhelm
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Mels, C.M.C., Loots, I., Schwedhelm, E. et al. Nitric oxide synthesis capacity, ambulatory blood pressure and end organ damage in a black and white population: the SABPA study. Amino Acids 48, 801–810 (2016). https://doi.org/10.1007/s00726-015-2128-5

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