Target-organ damage in adolescent hypertension.: Analysis of potential influencing factors, especially nitric oxide and endothelin-1

Background and purpose: To assess the role of the nitric oxide-endothelia imbalance in the development of target-organ damages (carotid intima-media thickness and left ventricular mass index) in adolescent hypertension. Methods: 125 adolescents - 67 hypertensive and 58 normotensive - underwent routine anthropology (height, weight) and blood pressure measurements, and laboratory (glucose, cholesterol and triglyceride levels) testing as well as sampling blood for determination of the plasma concentrations of nitric oxide (NOx) and endothelia-1 (ET-1), followed by measurement of the carotid intima-media thickness (IMT) and left ventricular mass index (LVMI). Results: Plasma concentration of NOx was significantly lower (27.7 +/- 13.7 vs. 35.8 +/- 7.0 mu mol/l, respectively, p < 0.001) and ET-1 was higher (3.11 +/- 3.9 vs. 1.09 +/- 1.07 fmol/ml, respectively, p < 0.001) in hypertensive adolescents than that of controls. NOx negatively, endothelia positively correlated with blood pressure values, especially with systolic BP. An inverse relationship has been found between NOx and ET-1 concentrations (r=-0.29, p < 0.003). In this adolescent population body weight, systolic blood pressure and plasma ET-1 were the most important factors influencing IMT, whereas LVMI correlated with height and weight and systolic BP of the teenagers. Conclusions: NO/endothelia imbalance seems to play a role in the development of hypertension and target-organ damages in adolescence. Further studies are encouraged in order to clarify the pathophysiological role of NO/endothelia imbalance in adolescent hypertension. (c) 2006 Elsevier B.V. All rights reserved.