Abstract

This systematic review explores the intricate relationship between nitric oxide (NO) bioactivity and hypertension, drawing upon evidence from diverse geographical regions. The study synthesizes findings from research conducted in Switzerland, the USA, the United Kingdom, and India, among others, to elucidate the multifaceted mechanisms underlying hypertension pathogenesis. Key findings indicate that impaired NO bioactivity contributes significantly to hypertension, manifesting in reduced vasodilator response to endothelium-dependent vasodilation, arterial stiffness, increased pulse wave velocity, and chronic sympathetic nervous system activation. Additionally, investigations into the impact of hyperuricemia on NO synthesis and bioavailability reveal its potential role in hypertension and cardiovascular disease progression. The association between NO levels and hypertension severity underscores the physiological significance of NO in regulating blood pressure. While anti-hypertensive interventions promise to improve NO levels and endothelial function, their efficacy varies across studies. This review underscores the critical role of NO in hypertension management and advocates for tailored therapeutic strategies targeting NO pathways. Future research directions include elucidating the mechanisms linking NO dysfunction to hypertension and exploring novel therapeutic avenues to optimize blood pressure control and mitigate cardiovascular risk. By advancing our understanding of NO's role in hypertension, this study aims to inform precision medicine approaches for personalized hypertension management and contribute to reducing the global burden of cardiovascular disease

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