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Objective To assess the role of oxidative metabolism and nitric oxide synthesis for elucid ating their pathophysiological mechanisms in a Tibetan patient with essential hyp ertension. Methods The serum levels of total superoxide dismutase (T-SOD), malondialdehyde (MDA), total antioxidant capacity (T-AOC), nitric oxide (NO) and nitric oxide synthase (NOS) were assayed in sixty native Tibetans (thirty hypertensive patients and t hirty healthy volunteers as control). Results The levels of T-SOD, T-AOC, NO and NOS were significantly lower in the patient group than in the control group (P<0.01); MDA was significantly higher in the patient group than in the control group (P<0.01). The level of MDA ha d a strong negative correlation with T-SOD, T-AOC, NO and NOS (r=-0.82, -0.76, -0.79, -0.73, respectively, P<0.001 for all). Conclusion Tibetan patients with essential hypertension (EH) may have underlying oxidative metabolism dysfunction and depressed NO synthesis, both responsible for the hype rtensive process.