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Primer Hipertansiyonu Olan Normotansif Bireylerin Birinci Derece Yakınlarında Uyarılmış Endotel ve Renin-Anjiyotensin Sistem Fonksiyonu

The Function of Stimulated Endothelium and Renin-Angiotensin System in Normotensive Subjects With a Family History of Hypertension

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Abstract (2. Language): 
In this study, the aim is to observe the renin-angiotensin sys¬ tem (RAS) and endothelium after phlebotomy in healthy blood donors. Healthy blood donors were divided into two subgroups according to the presence of hypertensive relatives (Group 1) or not (Group 2). Plasma levels of renin, nitric oxide (NO) and plasminogen activator inhibitor 1 (PAI-1) were studied before and after phlebotomy in each group. 400-500 mL of blood was taken in phlebotomies as usual. NO levels were studied by chemoluminescence method, PAI-1 activity were studied bye chromogenic assay method and plasma renin activity were studied by enzymatic kinetic met¬ hods. No statistically significant difference was observed between the mean baseline plasma renin, NO and PAI-1 level of the two gro¬ ups. Evident increase was observed in the (stimulated) mean plas¬ ma levels of PRA, PAI-1 activity and NO levels after phlebotomy (p<0,001). The increase in mean plasma levels of PRA and PAI-1 activity is more evident in group 1 than group 2 after phlebotomy. Alt¬ hough mean plasma NO levels increased in both groups after phle¬ botomy, increase in group 1 was less than that in group 2. As a conclusion, increased renin, NO and PAI-1 response after phlebotomy in normotensive subjects with or without a family history of hypertension suggests the presence of abnormal RAS and endothelial function in the early stages of hypertension.
Abstract (Original Language): 
Bu çalışmada sağlıklı kan vericilerinde flebotomi sonrası uyarılmış renin-anjiyotensin sistemi (RAS) ve endotel aktivasyonunun tespit edilmesi amaçlandı. Çalışmaya sağlıklı kan vericileri, ailesinde hipertansiyon olmasına göre iki gruba ayrıldı; grup 1, ailede hipertansiyon öyküsü olan ve bu sebeple ileride hipertansiyon gelişimi açısından risk altında olan sağlıklı kan vericileri (Grup 1, n=75, 68E, 7K, 21-52) ve grup 2, ailede hipertansiyon öyküsü olmayan sağlıklı kan vericileri (Grup 2, n=75, 69E, 6K, 21-48). Her iki grupta flebotomi öncesi ve sonrası plazma renin, nitrik oksit (NO) ve plazminojen aktivatör inhibitör tip-1 (PAI-1) düzeyleri ölçüldü. Flebotomide standart olarak 400-500 mL kan alındı. NO dü¬ zeyleri kemolüminesans yöntemi ile, PAI-1 aktivite düzeyi kromojenik esey metodu ile ve plazma renin aktivitesi (PRA) düzeyi ise enzimatik ki¬ netik yöntemler kullanılarak ölçüldü. Ortalama bazal plazma renin, NO, ve PAI-1 aktivite düzeyleri açısından her iki grupta anlamlı bir fark sap¬ tanmadı. Flebotomi sonrası (uyarılmış) ortalama PRA, plazma PAI-1 aktivite ve NO düzeylerinde her iki grupta da belirgin artış saptandı (p<0.001). Flebotomi sonrası ortalama PRA (p<0.05, Şekil 4) ve plazma PAI-1 aktivite (p<0.005, düzey artışı grup 1'de grup 2'ye göre daha belir¬ gindi. Flebotomi sonrası ortalama plazma NO düzeyi her iki grupta da artmasına rağmen grup 1'deki artış grup 2'ye göre daha azdı. Sonuç olarak, ailesinde hipertansiyon öyküsü olan ve olmayan normotansif bireylerde, flebotomi sonrası artmış renin, NO ve PAI- 1 cevabı, hipertansiyonun erken evresinde RAS ve endotel fonksiyon anormalliğinin olduğunu düşündürmektedir.
FULL TEXT (PDF): 
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