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Because oxidative stress and inflammation are known to play important roles in the pathogenesis of cardiovascular events that occur most frequently in the morning, we studied the association between reactive oxygen species (ROS) formation by polymorphonuclear leukocytes (PMNs) or mononuclear cells (MNCs) and morning blood pressure (BP) rhythm. A total of 31 hypertensives in whom ambulatory BP monitoring was performed participated in this study. They were first divided into three groups according to their nocturnal BP rhythm (non-dippers, dippers and extreme dippers), and then into two groups according to their morning BP change (surge-type and sustained-type). ROS formation by PMNs and MNCs was measured by gated flow cytometry. C-reactive protein and traditional risk factors such as age, gender, body mass index, hemoglobin A1c, and total cholesterol were also measured. ROS formation by MNCs was significantly increased in extreme dippers (vs. dippers, p<0.05, n=11) and in morning BP surge-type hypertensives (vs. sustained-type, p<0.05, n=13). In patients who were both extreme dippers and morning BP surge-types, ROS formation by MNCs was significantly higher than that in other groups. These results suggest that both extreme dippers and morning BP surge-type hypertensives may suffer increased ROS formation by MNCs, and that increased ROS formation by MNCs may underlie morning strokes.

Because oxidative stress and inflammation are believed to play roles in the pathogenesis of cardiovascular diseases, oxidative stress in polymorphonuclear leukocytes (PMNs) and mononuclear cells (MNCs) has been measured. A total of 529 subjects participated this study. Intracellular oxidative stress in PMNs and MNCs was measured by gated flow cytometry using carboxyfluorescin diacetate bis-acetoxymethyl ester. C-reacting protein (CRP), insulin action (homeostasis model assessment), and traditional risk factors such as age, gender, body mass index, triglycerides, LDL cholesterol, HDL cholesterol, hemoglobin A(1c), and mean blood pressure were also measured. Multiple regression analysis revealed a significant correlation between mean blood pressure and PMN oxidative stress (r=0.104, P=0.018). It also demonstrated a significant correlation between hemoglobin A(1c) and PMN oxidative stress (r=0.112, P=0.021). A significant correlation was also found between CRP and MNC oxidative stress (r=0.116, P=0.008) by multiple regression analysis. In patients with both hypertension and diabetes, both PMN and MNC oxidative stress was increased (n=21, P=0.022 and P=0.006). These results suggest that both hypertension and diabetes lead to increased oxidative stress of PMNs and MNCs, and that CRP is related to MNC oxidative stress.

Background: An association between anxiety and depression and increased blood pressure (BP) and cardiovascular disease risk has not been firmly established. We examined the hypothesis that anxiety and depression lead to increased plasma catecholamines and to production of reactive oxygen species (ROS) by mononuclear cells (MNC) in hypertensive individuals. We also studied the role of BP in this effect. Methods: In Protocol 1, a cross-sectional study was performed in 146 hypertensive patients to evaluate whether anxiety and depression affect BP and ROS formation by MNC through increasing plasma catecholamines. In Protocol 2, a 6-month randomized controlled trial using a subtherapeutic dose of the α1-adrenergic receptor antagonist doxazosin (1 mg/day) versus placebo in 86 patients with essential hypertension was performed to determine whether the increase in ROS formation by MNC was independent of BP. Results: In Protocol 1, a significant relationship was observed between the following: trait anxiety and plasma norepinephrine (r = 0.32, P < .01); plasma norepinephrine and ROS formation by MNC (r = 0.36, P < .01); and plasma norepinephrine and systolic, diastolic, and mean BP (r = 0.17, P = .04; r = 0.26, P = .02; r = 0.23, P < .01, respectively). In Protocol 2, subtherapeutic doxazosin treatment (1 mg/day) had no significant effect on BP. However doxazosin significantly decreased ROS formation by MNC compared with placebo (P < .01). Conclusion: Trait anxiety may increase plasma norepinephrine and increase ROS formation by MNC independent of BP in hypertensive patients. [Copyright &y& Elsevier]