Changes Of Plasma Hydrogen Sulfide And Adrenomedullin In Patients With Essential Hypertension And Their Roles In Pathogenesis

OBJECTIVE: To determine levels of plasma hydrogen sulfide (H2S) and adrenomedullin in essential hepertension patients and investigate whether they are involved in the pathogenesis of essential hypertension.METHODS: 42 essential hypertension patients without medications were randomly enrolled as study group and assigned into 3 subgroups according to hypertension grouping criteria as "2004 China guidelines for prevention and treatment of hypertension": class â…  group (14 patients, 7male and 7 female), class â…¡ group (13 patients, 7male and 6 female), and class â…¢ group (15 patients, 8 male and 7 female). 10 healthy volunteer (5 male and 5 female) were enrolled as control group. Blood pressures were measured by mercury sphygmomanometer. Concentrations of plasma hydrogen sulfide (H2S) were determined by spectrometer, and adrenomedullin were analyzed by radioimmunoassay. Data were processed by student T test, F test, Q test, and correlation analysis. There was statistical difference when P<0.05 and significant statistical difference when P<0.01. RESULTS: (1) The levels of H₂S in hypertensives(37.08±10.36μmol/L) were significantly reduced than that of normal controls (50.98±6.23μmol/L, P <0.01);whereas the levels of adrenomedullin in hypertensives (27.28±5.93ng/L) were significantly increased than that of normal controls (20.51± 1.71 ng/L), P<0.01. (2)The concentrations of plasma H₂S in essential hypertension class â… , â…¡, â…¢ group were 47.73±3.87μmol/L, 37.38±4.60μmol/L, 26.87±7.56μmol/L respectively. There were significant differences between any two of the groups (P<0.01);the levels of adrenomedullin in the three groups were 20.63±1 .82ng/L, 27.18±2.23ng/L, 33.57±2.98ng/L respectively, and the differenceswere also significant (PO.01). (3) In hypertension group, there was negative correlation between plasma H2S and systolic or diastolic pressure (r= - 0.777, r=- 0.744, PO.01);there was no correlation between the level of H2S and age, BMI, cholesterol, triglyceride, orbloodsugar (r =-0.098, r = -0.040, r = 0.064, r =0.007, r = -0.028, P>0.05) , there was positive correlation between adrenomedullin level and systolic or diastolic pressure (r = 0.756, r = 0.675, P<0.01);there was no correlation between the level of adrenomedullin and age, BMI, cholesterol.triglyceride, or blood sugar (r = 0.301, r = 0.012, r = 0.162, r =0.142, r = 0.129, P>0.05) , and there was negative correlation between H2S level and adrenomedullin level (r=-0.852, PO.01) . CONCLUSION: The concentrations of plasma hydrogen sulfide (H2S) are lower in essential hypertension patients, and there is negative correlation between H2S level and blood pressure levels, whereas those of adrenomedullin are higher in essential hypertensives, and there is positive correlation between adrenomedullin level and blood pressure levels;and there is negative correlation between H2S level and adrenomedullin level. Because both hydrogen sulfide and adrenomedullin can relax vessels, the levels of H2S decrease in the hypertensives, which suggest that the shortage of H2S is one of motive factors of hypertension, whereas the levels of adrenomedullin increase secondarily, which prevents the development of hypertension and can protect body.