Central systolic blood pressure relates inversely to nitric oxide synthesis in young black adults: the African-PREDICT study

Lower nitric oxide (NO) bioavailabilty associates with hypertension in patients and elderly populations. With hypertension known to develop earlier in black populations, we compared both plasma and urinary NO-related markers and their associations with central systolic blood pressure (cSBP) and arterial stiffness in healthy young black and white adults. We included healthy black and white men and women (n = 1110; 20-30 years) and measured cSBP and pulse wave velocity (PWV), along with both plasma and urinary arginine, homoarginine, asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA), as well as urinary ornithine/citrulline, nitrite and nitrate. In addition, the urinary nitrate-to-nitrite ratio (UNOxR) was calculated. The black men and women had higher cSBP and higher plasma arginine and ADMA, but lower urinary nitrate and UNOxR (all p ≤ 0.003) than their white counterparts. In single and forward stepwise multiple regression analyses, we found an inverse association of cSBP (adj. R2 = 0.124; β = -0.134; p = 0.006) and plasma homoarginine in black men. Central SBP associated inversely with UNOxR in black women only (adj. R2 = 0.171; β = -0.130; p = 0.029). In the white women, cSBP associated positively with urinary ADMA (adj. R2 = 0.372; β = 0.162; p = 0.015). PWV associated inversely with plasma ADMA (adj. R2 = 0.253; β = -0.163; p = 0.024) in the white women only. The lower NO synthesis and the higher cSBP in our black cohort support the notion of a potential increased risk for future large artery stiffness and hypertension development in later life.