BACKGROUND: Reperfusion of infarcted myocardium by thrombolysis is the major technique used to restore blood supply. Reperfusion, however, is associated with a burst of oxygen consumption, with the resultant excessive generation of free radicals causing reperfusion injury. OBJECTIVE: In the present study, the effect of vitamin E administration on the status of free radical-mediated injury and blood pressure in post reperfusion hypertensive patients with myocardial infarction is assessed. METHOD:POST REPERFUSION HYPERTENSIVE PATIENTS WERE DIVIDED INTO THREE GROUPS: those not receiving a beta-blocker (group I), those receiving acetylsalicylic acid (ASA) plus a beta-blocker (group II) and those receiving ASA, a beta-blocker and 400 mg vitamin E (group III). Groups II and III were comprised of patients from group I. Levels of malondialdehyde (MDA) and xanthine oxidase (XO) activity in blood were used as an index of oxidative stress. These parameters, along with blood pressure, were monitored in these groups. RESULTS: Patients not receiving a beta-blocker had elevated levels of MDA and XO activity when compared with healthy persons (P<0.0005 both for MDA and XO). Compared with group I, patients receiving a beta-blocker plus ASA (group II) had a significant decrease in the activity of XO (P<0.005) and the levels of MDA (P<0.005). When vitamin E was incorporated in the treatment, there was highly significant decrease in these oxidative stress parameters compared with groups I and II (P<0.0005 for XO and MDA). Use of vitamin E as an adjuvant in hypertensive therapy (group III) resulted in better management of blood pressure (systolic P<0.005, diastolic P>0.05) when compared with group II. CONCLUSION: Inclusion of vitamin E in antihypertensive therapy in post reperfusion hypertensive patients results in better management of blood pressure.
RCT Entities:
BACKGROUND: Reperfusion of infarcted myocardium by thrombolysis is the major technique used to restore blood supply. Reperfusion, however, is associated with a burst of oxygen consumption, with the resultant excessive generation of free radicals causing reperfusion injury. OBJECTIVE: In the present study, the effect of vitamin E administration on the status of free radical-mediated injury and blood pressure in post reperfusion hypertensivepatients with myocardial infarction is assessed. METHOD: POST REPERFUSION HYPERTENSIVEPATIENTS WERE DIVIDED INTO THREE GROUPS: those not receiving a beta-blocker (group I), those receiving acetylsalicylic acid (ASA) plus a beta-blocker (group II) and those receiving ASA, a beta-blocker and 400 mg vitamin E (group III). Groups II and III were comprised of patients from group I. Levels of malondialdehyde (MDA) and xanthine oxidase (XO) activity in blood were used as an index of oxidative stress. These parameters, along with blood pressure, were monitored in these groups. RESULTS:Patients not receiving a beta-blocker had elevated levels of MDA and XO activity when compared with healthy persons (P<0.0005 both for MDA and XO). Compared with group I, patients receiving a beta-blocker plus ASA (group II) had a significant decrease in the activity of XO (P<0.005) and the levels of MDA (P<0.005). When vitamin E was incorporated in the treatment, there was highly significant decrease in these oxidative stress parameters compared with groups I and II (P<0.0005 for XO and MDA). Use of vitamin E as an adjuvant in hypertensive therapy (group III) resulted in better management of blood pressure (systolic P<0.005, diastolic P>0.05) when compared with group II. CONCLUSION: Inclusion of vitamin E in antihypertensive therapy in post reperfusion hypertensivepatients results in better management of blood pressure.
Authors: A Warnholtz; G Nickenig; E Schulz; R Macharzina; J H Bräsen; M Skatchkov; T Heitzer; J P Stasch; K K Griendling; D G Harrison; M Böhm; T Meinertz; T Münzel Journal: Circulation Date: 1999-04-20 Impact factor: 29.690