Oxidative stress in hypertensive children before and after 1 year of antihypertensive therapy

Pediatr Nephrol. 2012 Oct;27(10):1943-51. doi: 10.1007/s00467-012-2193-x. Epub 2012 Jun 2.

Abstract

Background: The relation between primary hypertension (PH), target organ damage (TOD) and oxidative stress (SOX) is not known.

Methods: We assessed SOX in 86 children with PH before and after 12 months of standard non-pharmacological and pharmacological therapy based on renin-angiotensin system blockade.

Results: Patients with left ventricular hypertrophy (LVH) and with carotid intima-media thickness (cIMT) >2SDS had higher thiobarbituric acid reactive substances (TBARS) concentrations in comparison to patients without LVH or with normal cIMT. Patients with metabolic syndrome (MS) had lower activity of gluthatione peroxidase, higher asymmetric dimethyloarginine (ADMA) and oxidized LDL cholesterol (oxyLDL) in comparison to patients without MS. TBARS correlated with left ventricular concentric hypertrophy, cIMT, albuminuria and SBP/24 h. ADMA and oxyLDL correlated with CRP and TG/HDL ratio. After 1 year of antihypertensive treatment blood pressure, TOD and prevalence of MS decreased. TBARS decreased and glutathione concentrations increased. The decrease of TBARS concentration correlated with the decrease of body mass index (BMI). Decrease of oxyLDL and ADMA correlated with increased insulin sensitivity, however markers of SOX did not correlate with BP decrease.

Conclusion: SOX in children with PH correlates with TOD, metabolic abnormalities, changes in fat amount and improvement of insulin sensitivity, but not with BP decrease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adiposity
  • Adolescent
  • Albuminuria / blood
  • Albuminuria / etiology
  • Analysis of Variance
  • Angiotensin II Type 1 Receptor Blockers / therapeutic use*
  • Angiotensin-Converting Enzyme Inhibitors / therapeutic use*
  • Antihypertensive Agents / therapeutic use*
  • Arginine / analogs & derivatives
  • Arginine / blood
  • Biomarkers / metabolism
  • Blood Pressure / drug effects
  • C-Reactive Protein / metabolism
  • Carotid Artery Diseases / blood
  • Carotid Artery Diseases / etiology
  • Carotid Artery Diseases / pathology
  • Carotid Intima-Media Thickness
  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Cholesterol, LDL / blood
  • Female
  • Glutathione Peroxidase / blood
  • Humans
  • Hypertension / blood
  • Hypertension / complications
  • Hypertension / drug therapy*
  • Hypertension / physiopathology
  • Hypertrophy, Left Ventricular / blood
  • Hypertrophy, Left Ventricular / diagnostic imaging
  • Hypertrophy, Left Ventricular / etiology
  • Insulin Resistance
  • Lipoproteins, LDL / blood
  • Male
  • Metabolic Syndrome / blood
  • Metabolic Syndrome / complications
  • Metabolic Syndrome / physiopathology
  • Oxidative Stress / drug effects*
  • Poland
  • Severity of Illness Index
  • Thiobarbituric Acid Reactive Substances / metabolism
  • Time Factors
  • Treatment Outcome

Substances

  • Angiotensin II Type 1 Receptor Blockers
  • Angiotensin-Converting Enzyme Inhibitors
  • Antihypertensive Agents
  • Biomarkers
  • Cholesterol, LDL
  • Lipoproteins, LDL
  • Thiobarbituric Acid Reactive Substances
  • oxidized low density lipoprotein
  • N,N-dimethylarginine
  • C-Reactive Protein
  • Arginine
  • Glutathione Peroxidase