Increase of plasma atrial natriuretic peptide levels after sublingual administration of nifedipine in essentially hypertensive patients

Rappelli, A; Dessı̀-Fulgheri, Paolo; Bandiera, Francesco; Noto, G. Di

doi:10.1016/0167-5273(89)90089-2

Cited by 4 publications

(3 citation statements)

References 12 publications

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“…All patients were receiving drugs with potent haemodynamic effects which might influence ANF levels. However, drugs such as beta‐blockers without intrinsic sympathomimetic activity (ISA) do not affect resting plasma ANF levels in patients with coronary heart disease [29] and calcium‐blocking agents have a modest acute but not a sustained effect on plasma ANF levels [30]. Since all our patients were investigated at least 2 h after medication and none were receiving beta‐blockers with ISA, it is highly improbable that plasma ANF was influenced acutely by the concomitant treatment.…”

Section: Discussionmentioning

confidence: 99%

Determinants of atrial natriuretic factor levels in coronary heart disease: significance of central pressures, heart chamber volumes and left ventricular mass

Keller

Møgelvang

Saunamäki

et al. 1989

Journal of Internal Medicine

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Atrial natriuretic factor (ANF) was determined in pulmonary and systemic arterial plasma during diagnostic left and right heart catheterization in twenty-three patients. In twenty of these patients ANF was subsequently measured in systemic arterial plasma during nuclear magnetic resonance (NMR) imaging of the heart with computation of left heart chamber volumes and left ventricular mass. Left ventricular end-diastolic pressure was the strongest independent predictor of pulmonary arterial plasma ANF, whereas cardiac index best predicted aortic plasma ANF. Both pulmonary and aortic plasma ANF correlated with systolic and diastolic pulmonary arterial pressure, left ventricular end-diastolic pressure and cardiac index. Left atrial volume index and left ventricular mass index did not correlate with systemic arterial plasma ANF whereas a positive linear correlation between left ventricular end-diastolic volume index and ANF could be demonstrated (r = 0.61, P less than 0.01). Left ventricular end-diastolic volume index was the most important independent predictor of systemic arterial plasma ANF. Systemic arterial plasma ANF might be a simple marker of left ventricular dilatation in patients with heart disease.

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Section: Discussionmentioning

confidence: 99%

Determinants of atrial natriuretic factor levels in coronary heart disease: significance of central pressures, heart chamber volumes and left ventricular mass

Keller

Møgelvang

Saunamäki

et al. 1989

Journal of Internal Medicine

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“…These findings also indicate that the increase of ANP plasma levels is not the result of a mechanical overload on the left cardiac chambers but the result of a pharmacological action (12). There are not available references concerning such medium-term studies with verapamil or other phenylalkylamines Studies concerning another category of calcium-entry blockers, the angioselective dihydropyridines arrived to conflictive results (13)(14)(15)(16)(17)(18)(19).…”

Section: Introductionmentioning

confidence: 87%

Atrial natriuretic peptide contributes to the antihypertensive action of many drugs

Papadopoulos

Kokkas

2003

Eur. J. Drug Metab. Pharmacokinet.

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Data derived from a 10 years research program of our team demonstrate that many categories of antihypertensive drugs like beta-adrenergic blockers, alpha1-adrenergic blockers, ACE inhibitors, AT1-receptor antagonists and calcium-entry blockers increase plasma atrial natriuretic peptide (ANP) levels after a medium-term treatment of patients suffering from moderate essential hypertension. ANP always increases despite the drop of the arterial pressure and the fact that the left atrial and ventricular diameters remain unchanged or slightly reduced. These findings indicate that the increase of ANP plasma levels is not the result of a mechanical overload in the left cardiac chambers but the result of a pharmacological action. In conclusion, ANP is a universal factor contributing to the antihypertensive action of many drugs.

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“…In man, the basal plasma levels of ANF appear to be increased by acute administration of dihydropyridine calcium channel blockers [18,19,22], and a marked decrease of plasma ANF has been observed during long-term calcium blocker treatment of systemic hypertension [15,17,25]. Rapid ventricular pacing leads to acute stimulation of ANF secretion, which can be almost completely inhibited by pre-treatment with the calcium antagonist verapamil [8].…”

Section: Introductionmentioning

confidence: 99%

The dihydropyridine calcium channel blocker BAY t 7207 attenuates the exercise induced increase in plasma ANF and cyclic GMP in patients with mildly impaired left ventricular function

Kentsch

Müller-Esch

Otter³

et al. 1995

Eur J Clin Pharmacol

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In man, chronic antihypertensive calcium antagonist treatment improves cardiac function and reduces plasma ANF concentrations. Physical exercise increases cardiac workload and plasma ANF levels. In the present study, we investigated the effects of acute administration of the dihydropyridine calcium antagonist BAY t 7207 (BAY) during bicycle exercise on plasma ANF and plasma cyclic GMP levels, on mean arterial pressure (MAP), heart rate (HR), and on natriuresis and urinary urodilatin excretion. In a randomized, double-blind placebo controlled cross-over trial, 8 patients (age 56.8 +/- 2.5 y) with documented coronary artery disease and mildly impaired left ventricular function (EF 50.0 +/- 1.3%), received oral BAY (20 mg) or placebo. Forty-five minutes after medication, patients underwent a standardised exercise bicycle test in the supine position (6 min 25 W, 6 min 50 W). Before exercise, MAP was lower after BAY (88.8 +/- 4.1 mmHg) than after placebo (95.7 +/- 3.5 mmHg; p = 0.024), and HR was higher after BAY (76.8 +/- 3.5 bpm) than after placebo (69.5 +/- 3.6 bpm; p = 0.049). Plasma ANF tended to be higher after BAY (31.2 +/- 5.6 pg/ml) than after placebo (26.7 +/- 5.0 pg/ml), and plasma cGMP was not different (BAY 3.4 +/- 0.3, placebo 3.8 +/- 0.3 pmol/ml). During exercise, the relative increases in HR (+43%) and MAP (+17%) were identical after BAY and placebo. In contrast, ANF levels during exercise increased by 130 +/- 28% after placebo but only by 36 +/- 11% after BAY (p = 0.011). In parallel, plasma cyclic GMP increased by 61 +/- 13% after placebo and by 20 +/- 8% after BAY (p = 0.013). At the end of exercise, the BAY-induced reduction in plasma cyclic GMP reflected the reduction in diastolic arterial pressure (r = 0.717; p = 0.045). Compared to placebo, BAY treatment increased the fractional excretion rate of sodium from 0.46 +/- 0.11 to 0.90 +/- 0.22% (p = 0.016), without relation to urinary urodilatin excretion. Thus, the calcium antagonist BAY t 7207 attenuated the exercise-induced increase in plasma ANF and cyclic GMP probably due to its vasodilator effect. The relationship between blood pressure and the ANF system during exercise, which parallels findings during chronic antihypertensive treatment, may open a perspective for early evaluation of long-term therapy with calcium channel blockers.

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Increase of plasma atrial natriuretic peptide levels after sublingual administration of nifedipine in essentially hypertensive patients

Cited by 4 publications

References 12 publications

Determinants of atrial natriuretic factor levels in coronary heart disease: significance of central pressures, heart chamber volumes and left ventricular mass

Determinants of atrial natriuretic factor levels in coronary heart disease: significance of central pressures, heart chamber volumes and left ventricular mass

Atrial natriuretic peptide contributes to the antihypertensive action of many drugs

The dihydropyridine calcium channel blocker BAY t 7207 attenuates the exercise induced increase in plasma ANF and cyclic GMP in patients with mildly impaired left ventricular function

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