Abstract
Objective: To investigate the plasma asymmetric dimethylarginine (ADMA) levels and l-arginine in the essential
hypertension (EH) patients without coronary artery disease. Patients and Methods: A total of 86 Chinese
patients were enrolled in this study. All patients received coronary multidetector-row computed tomography
to exclude distinct coronary stenosis and treadmill exercise testing to exclude microvascular angina pectoris.
The patients with normal blood pressure (n = 26) were set as the control group. The EH patients were divided
into three subgroups: the prehypertension group (n = 26), the stage 1 hypertension group (n = 26) and the stage
2 hypertension group (n = 8). The plasma ADMA and l-arginine concentrations were measured by a validated
high-throughput liquid chromatographic tandem mass spectrometric assay. Results: There was a significantly
higher ADMA level [0.028 (0.016) mmol/L vs. 0.021 (0.010) mmol/L, P = 0.002] and lower l-arginine to ADMA
ratio [1.42 (0.58) vs. 2.01 (0.99), P < 0.001] in the EH group compared with the control group. Among the EH
patients, the ADMA levels were increased by grades of hypertension [0.028 (0.011) mmol/L, 0.027 (0.014)
mmol/L, 0.035 (0.024) mmol/L, respectively, P < 0.001]. The ADMA level was independently related to the
systolic blood pressure (r = 1.047, P = 0.001). Conclusion: The plasma ADMA levels were significantly elevated
with grades of hypertension in EH patients and were positively related to the systolic blood pressure levels.

Key words: Asymmetric dimethylarginine, essential hypertension, l-arginine