, Volume 48, Issue 1, pp 63–73 | Cite as

l-Carnitine and Long-Chain Acylcarnitines are Positively Correlated with Ambulatory Blood Pressure in Humans: The SABPA Study

  • Catharina M. C. Mels
  • Aletta E. Schutte
  • Elardus Erasmus
  • Hugo W. Huisman
  • Rudolph Schutte
  • Carla M. T. Fourie
  • Ruan Kruger
  • Johannes M. Van Rooyen
  • Wayne Smith
  • Nicolaas T. Malan
  • Leoné Malan
Original Article


The prevalence of hypertension in sub-Saharan Africa is increasing rapidly, and treatment remains challenging. Although the use of l-carnitine in treatment has received much attention, studies reporting on physiological l-carnitine levels in hypertensives are limited. Our aim was to determine physiological levels of l-carnitine and acylcarnitines in African and Caucasian men, and to investigate associations between ambulatory blood pressure (BP) and carnitine levels. Participants included 101 African and 101 Caucasian teachers. Ambulatory BP measurements were conducted, and l-carnitine and acylcarnitine levels determined. African men showed significantly higher systolic BP (p < 0.001), diastolic BP (p < 0.001) and l-carnitine levels (p = 0.01). In both ethnic groups, partial regression analyses revealed a positive association between BP and l-carnitine, although in Caucasians it was with systolic (r = 0.20, p = 0.045), and in Africans with diastolic BP (r = 0.23, p = 0.023). After adjusting for confounders, an independent positive association between systolic (R 2 = 0.37, β = 0.12, p = 0.041) and diastolic BP (R 2 = 0.39, β = 0.14, p = 0.018) and l-carnitine and long-chain acylcarnitines (R 2 = 0.38, β = 0.17, p = 0.005 and R 2 = 0.39, β = 0.15, p = 0.011) were found, independent of ethnicity. Physiological l-carnitine levels were not only higher in Africans than in Caucasians but also above the expected reference range. Despite promising results on l-carnitine (and its short-chain derivatives) in hypertension treatment regimens, our findings paradoxically show that elevated BP is significantly associated with higher physiological l-carnitine and long-chain acylcarnitine levels.


Ambulatory blood pressure l-Carnitine Long-chain acylcarnitines Ethnicity Lipid biochemistry β-Oxidation Fatty acid metabolism Heart lipid metabolism Nuclear receptors 



Ambulatory blood pressure monitoring




Blood pressure


Carotid intima-media thickness


C-reactive protein


Cross-sectional wall area


Electrospray ionisation tandem mass spectrometry


Ferric reducing antioxidant power


γ-Glutamyl transferase


High-density lipoprotein


Long-chain fatty acids


Nω-nitro-l-arginine methyl ester


Mean arterial pressure


Organic cation transporter 2


Peroxisome proliferator-activated receptor α


Reactive oxygen species

SABPA study

Sympathetic activity and ambulatory blood pressure in Africans study



The Sympathetic Activity and Ambulatory Blood Pressure in Africans (SABPA) Study would not have been possible without the voluntary collaboration of the participants and the Department of Education, North-West Province, South Africa. We gratefully acknowledge the technical assistance of Mrs. Tina Scholtz, Dr Szabolcs Péter and Sr Chrissie Lessing. This study was supported by the National Research Foundation, South Africa; the North-West University, Potchefstroom, South Africa, and the Metabolic Syndrome Institute, France.

Conflict of interest

The authors declare no conflict of interest. This study was supported by the National Research Foundation, South Africa; the North-West University, Potchefstroom, South Africa; and the Metabolic Syndrome Institute, France.


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Copyright information

© AOCS 2012

Authors and Affiliations

  • Catharina M. C. Mels
    • 1
  • Aletta E. Schutte
    • 1
  • Elardus Erasmus
    • 2
  • Hugo W. Huisman
    • 1
  • Rudolph Schutte
    • 1
  • Carla M. T. Fourie
    • 1
  • Ruan Kruger
    • 1
  • Johannes M. Van Rooyen
    • 1
  • Wayne Smith
    • 1
  • Nicolaas T. Malan
    • 1
  • Leoné Malan
    • 1
  1. 1.Hypertension in Africa Research Team (HART)North-West UniversityPotchefstroomSouth Africa
  2. 2.Centre for Human MetabonomicsNorth-West UniversityPotchefstroomSouth Africa

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