Reactive metabolites of oxygen, lipid peroxidation, total antioxidant capacity and vitamin E in essential arterial hypertension.

Free radical oxidative stress has been implicated in the pathogenesis of a variety of human diseases. The purpose of this study was to explore the degree of oxidative stress in essential arterial hypertension (EAH). The study groups consisted of fifteen untreated EAH patients (WHO stages 1 and 2), aged 40 to 70 years, and fifteen, age and sex matched, normal controls. The levels of typical peroxidation products such as malondialdehyde and 4-hydroxyalkenals (with the LPO-586 test, Bioxytech), free radicals and other reactive oxygen metabolites (ROMs) (with the d-ROMs test, Diacron), vitamin E (with HPLC method) and total antioxidant capacity (with the TAS test, Randox) were determined in the plasma af all subjects. Compared to the control group EAH patients exhibited significantly higher ROMs levels (334.7 +/- 21.6 vs 249.2 +/- 23.3 Units, means values +/- S.E.M.), and of lipid peroxidation products (10.7 +/- 0.7 vs 8.09 +/- 0.9 nmol/ml). It must be noted that such increases were not observed in all EAH patients, but above all in those less young or with more severe hypertension. On the other hand no significant difference was found between EAH patients and normal controls as regards vitamin E concentration and total antioxidant capacity. These results suggest that EAH patients, in spite of their normal antioxidant defences, are more prone than normotensive subjects to oxidative stress because of an increased ROMs production. This could result in an inactivation of prostacyclin and NO, hence an enhancement of peripheral vascular resistance and an increase of hypertension. Another consequence might be an increased lipid peroxidation of low density lipoproteins, a condition which is known to be associated with accelerated atherosclerosis. The study of oxidant and antioxidant factors seems therefore useful in EAH patients in order to evaluate oxidative stress and to correct, if possible, the observed abnormalities with dietetic or pharmacologic therapy.