Abstract
Background: Oxidative stress may contribute to the etiology of hypertension in humans. Oxidative stress is an imbalance between reactive oxygen species (ROS) and antioxidant defense mechanisms, causing damage to biological macromolecules and dysregulation of normal metabolism and physiology. Amlodipine as an antihypertensive agent is a long-acting calcium channel blocker that dilates blood vessels and improves blood flow. The aim of this study was to assess the oxidative stress in hypertensive patients on Amlodipine treatment through the assessment of salivary Malondialdehyde (MDA) and superoxide dismutase (SOD) as a marker of oxidative stress.
 Material and method: 60 individuals were included in this study, divided into two groups; the first group composed of 30 hypertensive patients on Amlodipine antihypertensive agent. The second group, the control group, composed of 30 healthy subjects without any systemic disease and with almost healthy oral hygiene. Intraoral examination was done for each individual and salivary samples were collected with the salivary flow rate (F/R) which was calculated in ml per minute and pH was measured by pH meter. Salivary MDA and SOD were analyzed by using ELISA kit based on the principle of competitive enzyme immunoassay technique; the concentrations of markers were measured by spectrophotometer at 450nm in a microplate reader.
 Results: Salivary MDA was significantly higher in hypertensive patients compared to control, while salivary SOD was significantly lower in patients than control group. Salivary flow rate and pH was significantly lower in patients as compared to the control group.
 Conclusions: There is a relation between oxidative stress and hypertension. Salivary MDA and SOD can be used as potential marker for monitoring patients with Hypertension.
 Keywords: hypertension, Oxidative stress, Amlodipine, MDA and SOD
Highlights
Under normal conditions, reactive oxygen species (ROS) and the Hypertension is defined as a systolic blood byproducts of their reactions with various pressure (SBP) of 140 mm Hg or more, or a biomolecules are neutralized and converted into diastolic blood pressure (DBP) of 90 mm Hg or harmless molecules by the natural antioxidant more.[1]
Amlodipine results in a decrease in renal vascular resistance and an increase in glomerular filtration rate.[19] as the salivary flow rate (F/R) decreases, the concentrations of total protein, sodium, calcium, chloride, and bicarbonate as well as the pH decrease to various levels, whereas the concentrations of inorganic phosphate and magnesium raise.[20,21] This disagrees with Nimma, et al (2016) [22] who found that there was no significant relation between hypertension and unstimulated salivary F/R
The age of patients showed a significant negative correlation with salivary superoxide dismutase (SOD). These findings suggested that increased lipid peroxidation in patients may be caused by increased free radical production and/or decreased antioxidant defense, which agrees with the previous studies Gonca Akbulut, et al, (1999);(40) Mine Erdenİnal, et al, (2001);(41) Ramazan Ozcankaya, et al, (2002);(42) Ümit Mutlu Türkoğlua, et al, (2003)(43) which hypothesized that increased oxidative stress may play an important role in the aging process or versa verse
Summary
ROS and the Hypertension is defined as a systolic blood byproducts of their reactions with various pressure (SBP) of 140 mm Hg or more, or a biomolecules are neutralized and converted into diastolic blood pressure (DBP) of 90 mm Hg or harmless molecules by the natural antioxidant more.[1]. Different aldehydes which can be formed as Amlodipine (Norvasc), one of the secondary products during lipid peroxidation, antihypertension agents, is a long-acting calcium; malondialdehyde (MDA) propanol, hexanal, and Oxidative stress (OS) is an imbalance between the. On cellular and tissue proteins or DNA to form adducts resulting in biomolecular damages.[12] MDA is one of the most popular and reliable markers that determine oxidative stress in clinical situations[13] which is found to be contributed to the etiology of hypertension in humans.[14] hypertensive patients have impaired endogenous and exogenous antioxidant defense mechanisms.[15]. The aim of this study was to assess the oxidative stress in hypertensive patients on Amlodipine treatment through the assessment of salivary Malondialdehyde (MDA) and superoxide dismutase (SOD) as a marker of oxidative stress.
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