International Research Journal of Pharmacy and Pharmacology

International Research Journal of Pharmacy and Pharmacology Vol. 2(12), pp. 306-310, December 2012         
Copyright © 2012 International Research Journals


Full Length Research Paper

Reverse dipper pattern of blood pressure as an indicator of sympathetic over activity in patients with systemic sclerosis and its relation with serum asymmetric dimethylarginine (ADMA) level

Dr. Zuhal Ariturk1*, Dr. Sevin Dag2, Dr. Remzi Cevik2, Dr. Hatice Yüksel, Dr. Murat Yüksel1, Dr. Derya Uçmak4, Dr. Mustafa Oylumlu1, Dr. Ibrahim Batmaz2 and Dr. M.Akif Sarıyıldız2

1Dicle University, Medicine Faculty, Department of Cardiology, Diyarbakir-Turkey

2Dicle University, Medicine Faculty, Department of Physical Medicine and Rehabilitation, Diyarbakir-Turkey

3Dicle University, Medicine Faculty, Department of Biochemistry, Diyarbakir-Turkey

4Dicle University, Medicine Faculty, Department of Dermatology, Diyarbakir-Turkey

*Corresponding Author E-mail:;  Tel: 0090 5323338391; Fax:00904122488523

Received 24 September, 2012; Accepted October 15, 2012


Systemic sclerosis (SSc) is a multisystem disorder characterized by extensive vascular damage, with early generalized microangiopathy and fibrosis of the skin and internal organs. SSc is characterized by parasympathetic impairment and marked sympathetic over activity. The aim of this study was to investigate the potential relationship between serum asymmetric dimethylarginine (ADMA) levels and blood pressure pattern with sympathetic over activity in patients with SSc. Thirty patients with systemic sclerosis and thirty controls who had no cardiovascular risk factors were included in this study. All patients and the controls underwent a 24-hour holter recording and their plasma ADMA levels were measured.  A total of 10 patients had dipper status (33.3%), 16 patients had non-dipper status (53.3%), 2 patients had reverse dipper status (6.7%) and 2 patients had extreme dipper status (6.7%). ADMA levels were higher in SSc patients when compared with control group and especially significantly higher in SSc patients with reverse dipper status. The relationship between elevated ADMA serum levels and reverse dipper blood pressure patterns in patients with SSC may be the result of sympathetic over activity.

Keywords: 24-hour blood pressure monitoring, Systemic sclerosis, ADMA, reverse dipping status.

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