Red blood cell K+ could be a marker of K+ changes in other cells involved in blood pressure regulation

Association of sulfur content in erythrocytes with cardiovascular parameters and blood pressure

OBJECTIVE

The study aims at assessing the relationship between blood pressure, heart geometry parameters, and the erythrocyte content of sulfur, potassium, chlorine and phosphorus, in a group of patients with laboratory systolic and diastolic blood pressure (SBP, DBP) below 140 or 90 mm Hg, respectively, who were otherwise healthy and untreated.

METHODS

The study group consisted of 42 adults recruited in a primary care setting. The individuals were healthy, not undergoing any therapy and free from smoking. For each individual, data were obtained on: average 24-hour SBP and DBP, left ventricle geometry, complete blood count, lipids profile, fibrinogen, hs-CRP and the erythrocyte concentration of sulfur (S), potassium (K), chlorine (Cl) and phosphorus (P).

RESULTS

Multivariate regression analysis showed statistically significant relationships of diastolic posterior wall thickness (PWTd) and relative wall thickness (RWT) with the concentration ratio of sulfur and potassium (S/K) in erythrocytes: PWTd and RWT increase as the S/K ratio increases. Also, SBP was found to be positively correlated with the S/K ratio.

CONCLUSIONS

The increase in sulfur content in RBCs could be an indicator of the downregulation of nitric oxide (NO) erythrocyte bioavailability exerted by endogenously produced hydrogen sulfide (H2S), and, in consequence, a marker of the development of hypertension and/or adverse changes in heart geometry.

Concentration dependent effect of (-)-Epicatechin on Na(+) /K(+) -ATPase and Ca(2+) -ATPase inhibition induced by free radicals in hypertensive patients: comparison with L-ascorbic acid

Although the antioxidant properties of flavonoids are well documented, it is still unclear whether these effects are dependent on radical scavenging or iron chelating activities. Oxidative stress, a state of excessive reactive oxygen species (ROS) activity, is associated with vascular disease conditions such as hypertension. Both the anti- and pro-oxidant effects of tea catechins have been implicated in the alterations of cellular functions that determine their chemoprotective and therapeutic potentials in health and diseases. The present study examined the concentration dependent (10(-7) to 10(-4)  m) effects of (-)-epicatechin and L-ascorbic acid on Na(+) /K(+) -ATPase and Ca(2+) -ATPase activity in hypertensive patients and normal subjects. L-ascorbic acid has been used as a positive control to compare the effect of (-)-epicatechin. A significant (p < 0.0001) decrease in the activities of Na(+) /K(+) -ATPase and Ca(2+) -ATPase was observed in hypertensive patients compared with normal subjects. We report that (-)-epicatechin shows a significant (p < 0.001) dose-dependent protective effect against oxidative stress induced by tert-butyl hydroperoxide (t-BHP), which is manisfested as a decrease in the activity of erythrocyte Na(+) /K(+) -ATPase and Ca(2+) -ATPase, in hypertensive patients as well as normal subjects. The effect of L-ascorbic acid was also significant (p < 0.001) and was comparable with that of (-)-epicatechin.

Determination of potassium in red blood cells using unmeasured volumes of whole blood and combined sodium/potassium-selective membrane electrode measurements

Recent studies suggest that the measurement of intracellular potassium concentrations in red blood cells (RBC-K) can be a marker for assessing the risk, development, and treatment of hypertension. In this work, the combined use of miniature potassium- and sodium-selective membrane electrodes is evaluated as a simple means to determine RBC-K. The proposed method requires two separate sets of electrode measurements: (i) potassium and sodium concentrations in the plasma phase of an unmeasured volume of a whole blood sample, and (ii) determination of potassium and sodium concentrations in the same sample of blood after complete hemolysis by ultrasonic disruption of the RBC membranes. The dilution of sodium concentration after hemolysis can be used to determine hematocrit (Hct) (volume of red cells per unit volume of blood) of the blood. The concentration of potassium within the red blood cells (RBCs) is then calculated using the measured change in potassium levels before and after RBCs lysis and the hematocrit level determined from the sodium electrode measurements and/or a conventional centrifugation method. Good correlation for RBC-K between the proposed method and traditional flame photometry is observed for animal blood samples that possess the range of potassium levels found within human RBCs (80-120 mM). However, when potassium is much lower than that found in human RBCs (known to occur for certain animal species), the Hct measured by the sodium electrode method is falsely low, compared to traditional spun hematocrit values, because of an increased level of sodium within the RBCs, necessitating use of spun Hct levels to assess RBC-K accurately. It is envisioned that this new approach could be further miniaturized into a single-use disposable cartridge type electrode system that would enable rapid point-of-care screening of RBC-K levels in human subjects.

Potassium in hypertension

Potassium is the most important ion in the living cell, affecting almost every cellular function. Numerous clinical and epidemiologic studies support the knowledge that potassium is a fundamental factor in blood pressure regulation. The role of potassium in blood pressure regulation is reviewed in this article, focusing on its impact on the vascular vessel and the kidney, which are tissues strongly affected by potassium balance. The role of potassium on nitric oxide synthesis and superoxide formation is analyzed. Finally, the study of cell potassium as a marker for hypertension is discussed.