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World J Cardiol. Jun 26, 2014; 6(6): 353-366
Published online Jun 26, 2014. doi: 10.4330/wjc.v6.i6.353
Essential hypertension and oxidative stress: New insights
Jaime González, Nicolás Valls, Roberto Brito, Ramón Rodrigo
Jaime González, Nicolás Valls, Roberto Brito, Ramón Rodrigo, Laboratory of Oxidative Stress and Nephrotoxicity, Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Casilla 70058, Chile
Jaime González, Clinical Hospital, University of Chile, Casilla 70058, Chile
Author contributions: González J conducted the critical review of the evidence, wrote and revised the manuscript and designed figures; Valls N conducted the critical review of evidence, wrote the manuscript and designed tables; Brito R conducted the critical review of evidence and revised the manuscript; Rodrigo R wrote and revised the manuscript; all authors read and approved the final version of the manuscript.
Correspondence to: Ramón Rodrigo, MSc, Professor, Laboratory of Oxidative Stress and Nephrotoxicity, Molecular and Clinical Pharmacology Program, Institute of Biomedical Sciences, Faculty of Medicine, University of Chile, Independencia 1027, Santiago 7, Casilla 70058, Chile. rrodrigo@med.uchile.cl
Telephone: +56-2-9786126 Fax: +56-2-9786126
Received: December 1, 2013
Revised: March 1, 2014
Accepted: May 8, 2014
Published online: June 26, 2014
Abstract

Essential hypertension is a highly prevalent pathological condition that is considered as one of the most relevant cardiovascular risk factors and is an important cause of morbidity and mortality around the world. Despite the fact that mechanisms underlying hypertension are not yet fully elucidated, a large amount of evidence shows that oxidative stress plays a central role in its pathophysiology. Oxidative stress can be defined as an imbalance between oxidant agents, such as superoxide anion, and antioxidant molecules, and leads to a decrease in nitric oxide bioavailability, which is the main factor responsible for maintaining the vascular tone. Several vasoconstrictor peptides, such as angiotensin II, endothelin-1 and urotensin II, act through their receptors to stimulate the production of reactive oxygen species, by activating enzymes like NADPH oxidase and xanthine oxidase. The knowledge of the mechanism described above has allowed generating new therapeutic strategies against hypertension based on the use of antioxidants agents, including vitamin C and E, N-Acetylcysteine, polyphenols and selenium, among others. These substances have different therapeutic targets, but all represent antioxidant reinforcement. Several clinical trials using antioxidants have been made. The aim of the present review is to provide new insights about the key role of oxidative stress in the pathophysiology of essential hypertension and new clinical attempts to demonstrate the usefulness of antioxidant therapy in the treatment of hypertension.

Keywords: Hypertension, Oxidative stress, Endothelial dysfunction, Antioxidants

Core tip: This review focuses on one of the most prevalent diseases worldwide: hypertension, providing new insights about the key role of oxidative stress in the pathophysiology of essential hypertension and new clinical attempts to demonstrate the usefulness of antioxidant therapy in its treatment.