Nitric oxide and its relation to blood pressure control and target organ damage in hypertensive patients

Patient with essential hypertension have reduced endothelium dependent vasodilatation, this abnormality has been related to decreased activity of endothelium nitric oxide. To estimate nitric oxide level in hypertensive patients to verify its role in relation to blood pressure control and target organ damage in hypertensive patients. Sixty hypertensive patients participated in this study, 40 of whom without clinical evidence of target organ damage of whom 20 had uncontrolled blood pressure and the other 20 were controlled with antihypertensive therapy. Study also included 20 hypertensives with evidence of target organ damage. Ten normal non-hypertensive subjects volunteered as controls. They were all subjected to full clinical assessment and estimation of nitric oxide levels. Each of the hypertensive groups including controlled hypertensives, uncontrolled hypertensives and hypertensives with evidence of target organ damage had statistically significant lower nitric oxide levels compared to normotensive control subjects [p<0.000]. Controlled hypertensive group when compared to the uncontrolled hypertensive group still had a statistically significant difference of nitric oxide [p value 0.000] While hypertensive patients with evidence of target organ damage had a statistically significant low nitric oxide levels compared the controlled hypertensive group [p value < 0.001], they did not have a statistically significant difference in NO levels when compared to the uncontrolled hypertensive group [p value 0.5]. Hypertensive patients whether controlled or not; whether with target organ damage or not have low NO denoting an underlying endothelial dysfunction. Controlled hypertensives with acceptable blood pressure measurements still have evidence of endothelial dysfunction with low NO. Current antihypertensive therapy, though attaining acceptable blood pressure levels does not seem to tackle endothelial dysfunction in hypertensive patients. NO seems to be playing a crucial role in target organ damage in hypertensive patients

Circulating leptin and tumor necrosis factor: a in patients with sepsis: correlation with microbiologic findings

Forty-six critically ill patients with culture proven bacteremia participated in this study and classified into two groups [30 patients with severe sepsis and 16 patients with septic shock]. The control group composed of 20 subjects before elective surgery. Body mass index [BMI] was calculated for all subjects. Leptin and TNF-alpha concentrations were determined for all participants. Leptin and TNF- alpha were reassessed in eight patients who survived after severe sepsis. Blood cultures were obtained for all patients. Specimens from other sites were obtained as appropriate. All samples were cultured and the isolates were identified by standard microbiologic procedures. All patients received a full standard supportive care and an empiric antimicrobial treatment that was modified to reflect the in vitro susceptibility testing whenever appropriate. The study concluded that septic patients had an elevated leptin and TNF-alpha levels correlating with the severity of the disease. Patients with a pure Gram-negative infection had significantly higher leptin and TNF- alpha levels than those with a pure Gram-positive sepsis