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Nitric oxide-related markers link inversely to blood pressure in black boys and men: the ASOS and African-PREDICT studies

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Abstract

Nitric oxide plays an important role in maintaining endothelial function, while increased oxidative stress may lead to nitric oxide inactivation and cardiovascular disease. If nitric oxide biosynthesis/bioavailability is already suppressed early in life, it may potentially predispose an individual to the early development of cardiovascular disease. We therefore aimed to identify differences in nitric oxide-related markers (urinary nitrate, nitrite and the nitrate-to-nitrite ratio (UNOxR)) between young black and white individuals, and whether these markers are associated with blood pressure and carotid intima media thickness. We included black and white healthy boys (n = 80; aged 6–8 years) and men (n = 510; 20–30 years) and measured blood pressure and carotid intima media thickness, along with urinary biochemical markers including nitrate and nitrite. The black boys and men had lower nitrate and UNOxR (all p ≤ 0.003) than their white counterparts. In single and multiple regression analyses, we found an inverse association of diastolic blood pressure in the black boys (adj. R2 = 0.27; β = –0.32; p = 0.030), and systolic blood pressure in black men (adj. R2 = 0.07; β = –0.13; p = 0.036) with nitrate. Carotid intima media thickness associated inversely with UNOxR in the black men (adj. R2 = 0.02; β = –0.14; p = 0.023), but not in the boys. Lower urinary nitrate in black boys and young men was associated negatively with blood pressure, suggesting that potentially lower nitric oxide bioavailability in young black individuals may contribute to hypertension development in later life.

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Acknowledgements

The authors are grateful to all individuals participating voluntarily in both the African-PREDICT study and ASOS. The dedication of the support and research staff as well as students at the Hypertension Research and Training Clinic at the North-West University (Potchefstroom campus) is also duly acknowledged.

Funding

The African-PREDICT study: the research funded in this manuscript is part of an ongoing research project financially supported by the South African Medical Research Council (SAMRC) with funds from National Treasury under its Economic Competitiveness and Support Package; the South African Research Chairs Initiative (SARChI) of the Department of Science and Technology and National Research Foundation (NRF) of South Africa (GUN 86,895); SAMRC with funds received from the South African National Department of Health, GlaxoSmithKline R&D (Africa Non-Communicable Disease Open Lab grant), the UK Medical Research Council and with funds from the UK Government’s Newton Fund; as well as corporate social investment grants from Pfizer (South Africa), Boehringer-Ingelheim (South Africa), Novartis (South Africa), the Medi Clinic Hospital Group (South Africa) and in kind contributions of Roche Diagnostics (South Africa). The ASOS: this study was supported by grants from NRF South Africa and the South African Sugar Association (SASA). Any opinion, findings, and conclusions or recommendations expressed in this material are those of the authors, and therefore the NRF does not accept any liability in this regard.

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Correspondence to Ruan Kruger.

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Participants were fully informed about the objectives of both studies (written informed consent and assent were obtained from all participants included in the study). All procedures performed in the study involving human participants were in accordance with the ethical standards of the institutional and/or national research committee (Health Research Ethics Committee of the North-West University; ASOS: NWU-00007-15-A1; African-PREDICT study: NWU-00001-12-A1) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards (Carlson et al. 2004).

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Craig, A., Mels, C.M.C., Schutte, A.E. et al. Nitric oxide-related markers link inversely to blood pressure in black boys and men: the ASOS and African-PREDICT studies. Amino Acids 52, 639–648 (2020). https://doi.org/10.1007/s00726-020-02842-3

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