Abstract-This study was designed to test the hypothesis that stimulation of nicotinamide adenine dinucleotide/ nicotinamide adenine dinucleotide phosphate (NADH/NADPH) oxidase is involved in increased vascular superoxide anion (⅐O 2 Ϫ ) production in spontaneously hypertensive rats (SHR). The study was performed in 16-week-old and 30-week-old normotensive Wistar-Kyoto rats (WKY 16 and WKY 30 , respectively) and in 16-week-old and 30-week-old SHR (SHR 16 and SHR 30 , respectively). In addition, 16-week-old SHR were treated with oral irbesartan (average dose 20 mg/kg per day) for 14 weeks (SHR 30 -I). Aortic NADH/NADPH oxidase activity was determined by use of chemiluminescence with lucigenin. The expression of p22phox messenger RNA was assessed by competitive reverse transcription-polymerase chain reaction. Vascular responses to acetylcholine were determined by isometric tension studies. Aortic wall structure was studied, determining the media thickness and the cross-sectional area by morphometric analysis. Whereas systolic blood pressure was significantly increased in the 2 groups of hypertensive animals compared with their normotensive controls, no differences were observed in systolic blood pressure between SHR 30 and SHR 16 . No other differences in the parameters measured were found between WKY 16 and SHR 16 . In SHR 30 compared with WKY 30 , we found significantly greater p22phox mRNA level, NADH/NADPH-driven ⅐O 2 Ϫ production, media thickness, and cross-sectional area and an impaired vasodilation in response to acetylcholine. Treated SHR had similar NADH/NADPH oxidase activity and p22phox expression as the WKY 30 group. The vascular functional and morphological parameters were improved in SHR 30 -I. These findings suggest that an association exists between p22phox gene overexpression and NADH/NADPH overactivity in the aortas of adult SHR. Enhanced NADH/NADPH oxidase-dependent ⅐O 2 Ϫ production may contribute to endothelial dysfunction and vascular hypertrophy in this genetic model of hypertension.

Background-This study was designed to investigate whether the serum concentration of the carboxy-terminal propeptide of procollagen type I (PIP), a marker of collagen type I synthesis, is related to myocardial fibrosis in hypertensive patients. Methods and Results-The study was performed in 26 patients with essential hypertension in which ischemic cardiomyopathy was excluded after a complete medical workup. Right septal endomyocardial biopsies were performed in hypertensive patients to quantify collagen content. Collagen volume fraction (CVF) was determined on picrosirius red-stained sections with an automated image analysis system. The serum concentration of PIP was measured by specific radioimmunoassay. Compared with normotensives, both serum PIP and CVF were increased (PϽ0.001) in hypertensives. A direct correlation was found between CVF and serum PIP (rϭ0.471, PϽ0.02) in all hypertensives. Histological analysis revealed the presence of 2 subgroups of patients: 8 with severe fibrosis and 18 with nonsevere fibrosis. Serum PIP was higher (PϽ0.05) in patients with severe fibrosis than in patients with nonsevere fibrosis. Using receiver operating characteristic curves, we observed that a cutoff of 127 g/L for PIP provided 78% specificity and 75% sensitivity for predicting severe fibrosis with a relative risk of 4.80 (95% CI, 1.19 to 19.30). Conclusions-These results show a strong correlation between myocardial collagen content and the serum concentration of PIP in essential hypertension. Although preliminary, these findings suggest that the determination of PIP may be an easy and reliable method for the screening and diagnosis of severe myocardial fibrosis associated with arterial hypertension.

Abstract-An association of increased apoptosis with overactivity of the local angiotensin-converting enzyme has been reported in cells from the left ventricle of adult rats with spontaneous hypertension (SHR). To gain insight into the regulation of cardiac apoptosis in arterial hypertension, we investigated the expression of the proteins Bcl-2 (an inhibitor of apoptosis) and Bax (an inducer of apoptosis) in the left ventricle of 30-week-old normotensive Wistar-Kyoto rats (WKY), SHR, and SHR treated with the angiotensin II type 1 receptor (AT 1 ) antagonist losartan (20 mg ⅐ kg) during 14 weeks before death. The density of apoptotic cells was assessed by direct immunoperoxidase detection of biotin-labeled deoxyuridin nucleotides. The expression of Bcl-2 and Bax was assessed by Western blot analysis. Compared with WKY, untreated SHR exhibited increased (PϽ0.05) apoptosis, increased (PϽ0.01) Bax, and similar Bcl-2. The Bcl-2/Bax ratio (an inverse index of cell susceptibility to apoptosis) was lower (PϽ0.05) in untreated SHR than in WKY. The chronic administration of losartan was associated with the normalization of apoptosis, Bax expression, and the Bcl-2/Bax ratio in treated SHR. No changes in the expression of Bcl-2 were observed in these rats after treatment. No significant changes in the apoptotic density were observed between treated SHR with normal blood pressure and treated SHR with abnormally high blood pressure at the end of the treatment period. These results suggest that an association exists between increased apoptosis and overexpression of Bax oncoprotein in cells from the left ventricle of adult SHR. Chronic blockade of AT 1 receptors prevents Bax overexpression and normalizes apoptosis in the left ventricle of SHR independently of its hemodynamic effect. On the basis of our findings, it can be proposed that the interaction of angiotensin II with its AT 1 receptors may participate in the stimulation of Bax protein, which in turn renders cells from the left ventricle of SHR more susceptible to apoptosis. (Hypertension. 1998;32:280-286.)

Abstract-It has been suggested that left ventricular fibrosis in spontaneously hypertensive rats (SHR) is the result of both exaggerated collagen synthesis and insufficient collagen degradation. We have shown previously that chronic treatment with the angiotensin II type 1 receptor antagonist losartan results in diminished synthesis of collagen type I molecules and reversal of myocardial fibrosis in SHR. This study was designed to investigate whether losartan also affects the extracellular degradation of collagen type I fibers in the left ventricle of SHR. 4 -9 Chronic blockade of the angiotensin II type 1 (AT 1 ) receptor with losartan resulted in the normalization of collagen synthesis and reversal of left ventricular fibrosis in SHR, which suggests a role for angiotensin II in increased collagen synthesis in that model. 6 The excess of ventricular collagen in patients with hypertensive LVH may be a result of both exaggerated collagen synthesis and inadequate collagen degradation. 10,11 The ratelimiting step in the extracellular degradation of collagen is the catalytic cleavage by interstitial matrix metalloproteinases (MMPs). 12 Nine MMPs have been identified, cloned, and sequenced, and these are divided into 3 groups (collagenase, stromelysin, and gelatinase) that are based broadly on substrate preferences. Interstitial collagenase (MMP-1) accounts for the degradation of up to 40% of newly synthesized collagen type I and type III in different tissues. 13 The MMP activity is regulated by a family of naturally occurring tissue inhibitors of metalloproteinases (TIMPs). 12,14 Four members of this family have been identified: TIMP-1, TIMP-2, TIMP-3, and TIMP-4. Unlike the other TIMPs, TIMP-1 is synthesized by most types of connective tissue cells, acts against all members of the MMPs family of enzymes, and is