Zanco Journal of Medical Sciences
Skip Navigation Links
Available Issues
Editorial Board
Information for Authors
Review Process
Links and Contacts
  Zanko J Med Sci:  Apr. 2018; 22 (1): 32-40

The role of some oxidative stress and inflammatory factors in essential hypertension

Julian Yonan Ismaeil *, Shatha Rouf Moustafa **


* Directorate of Health, Erbil, Iraq.

** Department of Clinical Biochemistry, College of Pharmacy, Hawler Medical University, Erbil, Iraq.


Background and Objective: Oxidative stress and inflammation are cooperative events involved in essential hypertension development. This study aimed to evaluate the association of N-terminal pro-Brain natriuretic peptide, matrix-metalloprotinase-9 and 8-oxo2-deoxyguanosine with the essential hypertension, detect the effect of other confounding factors like the stage of the disease and gender, and estimate the correlation between the selected parameters.

Methods: This case-control study was performed at College of Pharmacy, Hawler Medical University on 50 hypertensive patients of both genders with essential hypertension as well as 45 matched age–gender adults were also enrolled in this study as a control group. The selected parameters were analyzed using ELISA technique.

Results: There was a significant elevation in the serum levels of N-terminal pro-Brain natriuretic peptide, matrix-metalloprotinase-9 and 8-oxo2-deoxyguanosine in patients with essential hypertension as compared with the controls. The mean serum levels N-terminal pro-Brain natriuretic peptide, matrix-metalloprotinase-9 and 8-oxo2-deoxyguanosine were increased significantly according to the stage progression of the disease P ˂0.001. No gender effects could be found. 

Conclusion: Data suggested an association between circulating biomarkers (NT-proBNP, MMP -9, 8-oxo-2-dG) with the development of essential hypertension, there was a significant elevations in the serum selected parameters level in patients as compared with the control group.

Keywords: EHT; NT-proBNP; MMP -9; 8-oxo-2-dG.


1. Castro MM, Tanus-Santos JE. Inhibition of matrix metalloproteinases (MMPs) as a potential strategy to ameliorate hypertension-induced cardiovascular alterations. Curr Drug Target 2013; 14(3):335-43.

2. Oliveras A, de la Sierra A. Resistant hypertension: patient characteristics, risk factors, co-morbidities and outcomes. J Hum Hypertens 2014; 28(4): 213-7.

3. Page-McCaw A, Ewald AJ, Werb Z. Matrix metalloproteinases and the regulation of tissue remodelling. Nat Rev Mol Cell Biol 2007; 8(3):221-33.

4. Fontana V, Silva PS, Gerlach RF, Tanus-Santos JE. Circulating matrix metalloproteinases and their inhibitors in hypertension. Clin Chim Acta 2012; 413(7-8):656-62.

5. Dimitroulas T, Giannakoulas G, Karvounis H, Gatzoulis MA, Settas L. Natriuretic peptides in systemic sclerosis-related pulmonary arterial hypertension. Semen Arthritis Rheum 2010; 39(4):278-84.

6. Thakkar V, Stevens WM, Prior D, Moore OA, Byron J, Liew D, et al. N-terminal pro-brain natriuretic peptide in a novel screening algorithm for pulmonary arterial hypertension in systemic sclerosis: a case-control study. Arthritis Res Ther 2012; 14(3):R143.

7. Lainchbury JG, Troughton RW, Strangman KM, Frampton CM, Pilbrow A, Yandle TG, et al. N-terminal pro-B-type natriuretic peptide-guided treatment for chronic heart failure: results from the BATTLESCARRED (NT-proBNP- Assisted Treatment To Lessen Serial Cardiac Readmissions and Death) trial. J Am Coll Cardiol 2009; 55(1):53-60.

8. Delaney S, Jarem DA, Volle CB, Yennie CJ. Chemical and biological consequences of oxidatively damaged guanine in DNA. Free Radic Res 2012; 46(4):420-41.

9. Krakoff LR , Gillespie RL , Ferdinand KC , Fergus IV , Akinboboye O , Williams KA , et al. 2014 hypertension recommendations from the eighth joint national committee panel members raise concerns for elderly black and female populations. J Am Coll Cardiol 2014; 64(4):394-402.

10. Toda K, Sato Y, Hara T, Hijiya K, Kaneko R, Okada T, et al. Correlates of NT-proBNP concentration in patients with essential hypertension in absence of congestive heart failure. J Clin Lab Anal 2010; 24(1):12-6.

11. Paget V, Legedz L, Gaudebout N, Girerd N, Bricca G, Milon H, et al. N-Terminal pro-brain natriuretic peptide a powerful predictor of mortality in hypertension. Hypertension 2011; 57(4):702-9.

12. Bricca G , Lantelme P. Natriuretic peptides: Ready for prime-time in hypertension? Arch Cardiovasc Dis 2011; 104(6-7):403-9.

13. Roselló-Lletí E, Calabuig JR, Morillas P, Cortés R, Martínez-Dolz L, Almenar L, et al. Variability of NT-proBNP and its relationship with inflammatory status in patients with stable essential hypertension: A 2-year follow-up study. PLoS ONE 2012; 7(2):e31189.

14. Malavazos AE, Morricone L, Marocchi A, Ermetici F, Ambrosi B, Corsi MM. N-terminal pro-B-type natriuretic peptide and echocardiographic abnormalities in severely obese patients: correlation with visceral fat. Clinical Chemistry 2006; 52 (6):1211- 3.

15. Mouly-Bertin C, Bissery A, Milon H, Dzudie A, Rabilloud M, Bricca G, et al. N-terminal pro-brain natriuretic peptide: a promising biomarker for the diagnosis of left ventricular hypertrophy in hypertensive women. Arch Cardiovasc Dis 2008; 101(5):307-15.

16. Zhou S, Feely J, Spiers JP, Mahmud A. Matrix metalloproteinase-9 polymorphism contributes to blood pressure and arterial stiffness in essential hypertension. J Hum Hypertens 2007; 21(11):861-7. 

17. Raffetto JD, Khalil RA. Matrix metalloproteinases and their inhibitors in vascular remodeling and vascular disease. Biochem Pharmacol 2008; 75(2):346-59.

18. Friese RS , Rao F, Khandrika S, Thomas B, Ziegler MG, Schmid-Schönbein GW, et al. Matrix metalloproteinases: Discrete elevations in essential hypertension and hypertensive end-stage renal disease. Clin Exp Hypertens 2009; 31(7):521-33.

19. Berg G, Miksztowicz V, Schreier L. Metalloproteinases in metabolic syndrome. Clin Chim Acta 2011; 412(19-20):1731-9.

20. Gkaliagkousi E , Doumas M, Gavriilaki E, Triantafyllou A, Vogiatzis K, Anyfanti P, et al. Elevated levels of MMP-9 in untreated patients with stage I essential hypertension. Clin Exp Hypertens 2012; 34(8):561-6.

21. Kurihara T , Shimizu-Hirota R, Shimoda M, Adachi T, Shimizu H, Weiss SJ, et al. Neutrophil-Derived Matrix Metalloproteinase 9 Triggers Acute Aortic Dissection. Circulation 2012; 126(25):3070-80.

22. Ferri J, Martínez-Hervás S, Espinosa O, Fandos M, Pedro T, Real JT, et al. 8-oxo-7,8-dihydro-2'-deoxyguanosine as a marker of DNA oxidative stress in individuals with combined familiar hyperlipidemia. Med Clin (Barc) 2008; 131(1): 1-4.

23. Mansego ML , Redon J, Martinez-Hervas S, Real JT, Martinez F, Blesa S, et al. Different impacts of cardiovascular risk factors on oxidative stress. Int J Mol Sci 2011; 12(9):6146-63.

24. Torres-Ramalho P, Paulo Araújo J, Bettencourt P, Luís M. Natriuretic peptides in aortic stenosis. Rev Port Cardiol 2012; 31(10):655-60.

25. Toda K , Sato Y, Hara T, Hijiya K, Kaneko R, Okada T, et al. Correlates of NT-proBNP concentration in patients with essential hypertension in absence of congestive heart failure. J Clin Lab Anal 2010; 24(1):12-6.