| Objective Pathogenesis of hypertension is complicated, recent research found that the endothelial dysfunction is related to the pathogenesis of hypertension.Endothelin -1 (ET-1) and nitric oxide (NO) are important markers that responds to vascular endothelial cell function. Grade 1 Hypertension and Grade 2 Hypertension are the initial stage of essential hypertension,at this stage blood pressure control is effective to prevent hypertension-induced cardiovascular complications, and has important significance to improve the prognosis of patients with hypertension.In this study we compared concentration difference of plasma levels of ET-1 in healthy subjects and patients with grade 1 and 2 essential hypertension.Observe the change of plasma endothelin -1 and nitric oxide level in patients with essential hypertension before and after the treatment of irbesartan.To explore the relationship between ET-1, NO and the occurrence and development of hypertension.Study the endothelial protective effects of irbesartan.Data and methods We selected 80 grade 1 hypertension patients,80 grade 2 hypertension patients who were newly diagnosed and 40 healthy subjects as grade 1 hypertension group, grade 2 hypertension group and control group.All groups were excluded the cases that suffering the disease can affect the concentration of plasma endothelin.And three groups have no significant difference of age, sex, weight。(p> 0.05).All groups have morning fasting cubital vein blood 10ml,and prohibit alcohol and tobacco before this.Place the 5ml blood samples respectively into 2 test tubes containing heparin anticoagulant and shake.Within 30 minutes centrifuge the samples in 1000 transfer/ minute for 15 minutes.Siphon the supernatant and preserve in -80℃refrigerator waiting for test.Determine the concentration of ET-1 and NO by enzyme-linked immunosorbent assay (ELISA), Nitrate reduction assay.Operate strictly in accordance with human endothelin-1 ELISA kit instructions and the total nitric oxide assay kit instructions。Determine the levels of plasma ET-1 and NO by Microplate Reader.The data analysis using statistical software SPSS17.0.Compared the plasma concentration of ET-1 of grade1 hypertension group, grade 2 hypertension group with control group using independent sample t test method. Re-determine the plasma concentrations of ET-1 and NO in 2 hypertension groups after have irbesartan continuous for 6 weeks.The determination as well as the former.The data obtained in plasma ET-1 and NO compared with before treatment, using paired t test to analyze the concentration difference.Results①Before treatment, the plasma concentration of ET-1 levels in patients with grade 1 and grade 2 hypertension are higher than the control group, the differences are significant (P<0.01). The plasma concentration of ET-1 levels in patients with grade 2 hypertension is higher than the patients with grade 1 hypertension, the differences is significant (P<0.01).②After have irbesartan continuous for 6 weeks。Compare the plasma concentration of ET-1 levels in the patients with grade 1 hypertension before and after treatment. Compare to before treatment, the plasma concentration of ET-1 levels in after treatment is lower, the difference is significant (P<0.01). Compare the plasma concentration of ET-1 levels in the patients with grade 2 hypertension before and after treatment. Compare to before treatment, the plasma concentration of ET-1 levels in after treatment is lower, the difference is significant (P<0.01).③Before treatment, the plasma concentration of NO levels in patients with grade 1 and grade 2 hypertension are lower than the control group, the differences are significant (P< 0.01). The plasma concentration of NO levels in patients with grade 2 hypertension is lower than the patients with grade 1 hypertension, the differences is significant (P<0.01).④After have irbesartan continuous for 6 weeks。Compare the plasma concentration of NO levels in the patients with grade 1 hypertension before and after treatment. Compare to before treatment, the plasma concentration of NO levels in after treatment is higher, the difference is significant (P<0.01). Compare the plasma concentration of NO levels in the patients with grade 2 hypertension before and after treatment. Compare to before treatment, the plasma concentration of NO levels in after treatment is higher, the difference is significant (P<0.01).Conclusion The patients with grade 1 and 2 hypertension have the damage of endothelial function, the imbalance of ET-1/NO, and along with the progress of a aggravating trend。ET-1 and NO may play a role in the occurrence and development of hypertension. Irbesartan can reduce plasma ET-1, increase plasma NO, to improve the damage of endothelial, To provide a new therapeutic direction for the treatment of essential hypertension.
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