ADMA in hypertensive patients

In patients with essential hypertension ADMA levels have been shown to be two-fold higher than those in normotensive controls (Figure 17). In parallel, urinary excretion of NO metabolites (nitrate) is significantly decreased in hypertensive patients [30].

Experimental studies have also demonstrated that intra-arterial infusion of ADMA causes local vasoconstriction in the corresponding circulation [52]. Moreover, intravenous infusion of ADMA in doses which lead to circulating levels of about 2 µmol/l, total peripheral resistance is significantly increased [53].

These studies confirm previous data from animal experiments and suggest a pathophysiological role for ADMA in the regulation of normal blood pressure, and a pathophysiological role for this molecule in hypertension. This view is also supported by other studies which demonstrated a correlation between ADMA levels and the presence of left ventricular hypertrophy.

Figure 17. ADMA levels in plasma (a) and nitrate excretion into urine as a measure of systemic NO production (b) in patients with essential hypertension as compared to normotensive healthy controls (from [30] with kind permission of the publishers).