The impact of propranolol on nitric oxide and total antioxidant capacity in patients with resistant hypertension—evidence from the APPROPRIATE trial

• Main Authors: H. N. Ranasinghe, N. Fernando, S. Handunnetti, P. N. Weeratunga, P. Katulanda, S. Rajapakse, P. Galappatthy, G. R. Constantine
• Format: Article
• Language: English
• Published: BMC 2020-04-01
• Series: BMC Research Notes
• Subjects: Resistant hypertension; Oxidative stress; Antioxidant capacity; Nitrate; Nitrite
• Online Access: http://link.springer.com/article/10.1186/s13104-020-05067-5

Abstract Objectives The objective was to assess the effect of propranolol on oxidative stress and anti-oxidant potential in patients with resistant hypertension as a secondary analysis of the APPROPRIATE trial. This randomized double blinded clinical trial recruited patients with resistant hypertension and allocated forty patients to propranolol and placebo in 1:1 ratio. The pro-oxidant state (nitrate and nitrite) was assessed using modified Griess assay. The total anti-oxidant capacity was measured using ABTS assay. Results Analysis was performed for 18 patients from the propranolol group and 15 from the placebo group. A decline in end point ambulatory blood pressure (p = 0.031) and greater mean reduction in office SBP (29.7 ± 13.0 mmHg, p = 0.021) was noted in the propranolol arm. Nitrate and nitrite levels were lower at the end of a 90 day follow up period in both arms, with a greater mean reduction with propranolol. A significant increase in the AOC was noted in both arms with higher incremental value with Propranolol. The findings of this study do not demonstrate a statistically significant effect of propranolol on the oxidative stress/antioxidant balance in patients with resistant hypertension. The observed trends merit further evaluation.