Low Atrial Natriuretic Peptide Plasma Concentrations in 100 Patients with Essential Hypertension

Talartschik, J.; Eisenhauer, T.; Schrader, J; Schoel, G.; Buhr-Schinner, Heike; Scheler, F.

doi:10.1093/ajh/3.1.45

Cited by 10 publications

(4 citation statements)

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“…Despite the intensive investigation on a pathogenetic relationship between the ANP system and hypertension, low ANP does not necessarily play a causative role in hypertension [15][16][17], The present study rather indicates that ANP is not responsible for the modified hypertension. In 2K1C rats, a somewhat higher value, though insignificant, in the caffeine-ingested than in the control group may be a reflection of a higher blood pressure, as has been found in several forms of hypertension [12,18].…”

Section: Discussioncontrasting

confidence: 57%

Chronic Caffeine Ingest ion Exacerbates 2-Kidney, 1-Clip Hypertension and Ameliorates Deoxycorticosterone Acetate-Salt Hypertension in Rats

Choi¹,

Lee²,

Moon³

et al. 1993

Nephron

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The present study was aimed to determine the effect of caffeine on the development of renal hypertension. Two-kidney, 1-clip (2K1C) hypertension and deoxycorticosterone acetate (DOCA, 200 mg/kg, subcutaneous implantation) – salt (0.9% NaCl drinking) hypertension were instituted in Sprague-Dawley rats. They were then grouped into two groups each: one was supplemented with caffeine (0.1%) in their drinking solution and the other was not. Systolic blood pressure was measured up to 24 days. Caffeine exacerbated the development of 2K1C hypertension in association with a higher plasma renin concentration (PRC). Caffeine ingestion, however, did not exacerbate but ameliorated DOCA-salt hypertension in which PRC was comparable between the caffeine-ingested and control groups. Concentrations of plasma atrial natriuretic peptide (pANP) were significantly different between the caffeine-ingested and control groups neither in 2K1C nor in DOCA-salt rats, suggesting that ANP was not responsible for the modified blood pressure. Acute caffeine infusion (350 μg/min, 30 min) in anesthetized normotensive rats caused increases in urinary excretion (volume and sodium) and in PRC without significantly affecting the blood pressure and pANP. These results suggest that caffeine specifically exacerbates 2K1C hypertension through increasing renin release whereas it ameliorates DOCA-salt hypertension possibly through increasing renal excretion.

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Section: Discussioncontrasting

confidence: 57%

Chronic Caffeine Ingest ion Exacerbates 2-Kidney, 1-Clip Hypertension and Ameliorates Deoxycorticosterone Acetate-Salt Hypertension in Rats

Choi¹,

Lee²,

Moon³

et al. 1993

Nephron

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“…10 However, some investigators have reported that hypertensive individuals (especially the obese) may have low plasma natriuretic peptide levels, that is, they have a "natriuretic handicap." 4,30 Still others have reported no relations of plasma natriuretic peptides to blood pressure. 31 A potential reason for these conflicting results is that prior studies were cross-sectional and limited by selection bias (examination of hypertensive patients with varying durations and degrees of blood pressure elevation and confounded by treatment effects) and small samples.…”

Section: Discussionmentioning

confidence: 99%

Plasma Brain Natriuretic Peptide Levels and Blood Pressure Tracking in the Framingham Heart Study

et al. 2003

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Abstract-Increased brain natriuretic peptide (BNP) expression in the ventricles antedates elevated blood pressure (BP) in experimental studies. We hypothesized that higher plasma BNP levels in nonhypertensive individuals may be associated with a greater likelihood of future BP increase and/or hypertension. We evaluated the relations of plasma BNP to longitudinal BP tracking and incidence of hypertension in 1801 nonhypertensive Framingham Heart Study participants (mean age, 56 years; 57% women) by using gender-specific multivariable logistic regression. Progression of BP stage was defined as an increment of one or more BP categories, as classified by the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI). Hypertension was defined as a systolic BP Ն140 or diastolic BP Ն90 mm Hg or use of antihypertensive medications. On follow-up 4 years from baseline, progression of BP category was observed in 36.2% of men and 33.1% of women; hypertension developed in 16.4% of men and 15.5% of women. In multivariable models adjusting for known risk factors, elevated plasma BNP level was associated with increased risk of BP progression in men (odds ratio of 1.15 for trend across categories, Pϭ0.046) but not in women (Pϭ0.82). There were no significant trends of increasing incidence of hypertension across BNP categories in men or women. In our community-based sample, higher plasma BNP levels were associated with increased risk of BP progression in men but not women. Additional investigations are warranted to confirm these findings and elucidate the basis for these gender-related differences. Key Words: natriuretic peptides Ⅲ blood pressure Ⅲ hypertension, essential Ⅲ epidemiology Ⅲ hemodynamics T he natriuretic peptide (NP) family plays a key role in salt and water homeostasis and blood pressure regulation through direct vasodilator, diuretic, and natriuretic properties. 1,2 Brain natriuretic peptide (BNP), in particular, is a sensitive indicator of ventricular wall stress. [3][4][5][6] Experimental studies suggest that induction of BNP gene expression is one of the earliest responses to hemodynamic pressure overload and occurs before the development of left ventricular (LV) hypertrophy. 7 Indeed, in spontaneously hypertensive rats, increased BNP expression antedates the development of hypertension itself and precedes LV hypertrophy. 8 Therefore, it is not surprising that in several cross-sectional studies, plasma BNP and atrial natriuretic peptide levels have been reported to be elevated in subjects with hypertension and in individuals with LV hypertrophy. 9 -15 To our knowledge, the relations of plasma BNP levels to the incidence of hypertension or to longitudinal blood pressure tracking in the community have not been investigated.Investigators have reported that individuals prone to development of high blood pressure often have a hyperdynamic circulation antedating the onset of hypertension by several years. 16 Other researchers have underscored the role of increased cond...

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“…Although BNP is involved in blood pressure regulation, clinical studies have provided conflicting results on its concentration in patients with essential HTN. Some reports indicate that patients with HTN have plasma natriuretic peptides levels higher than normal subjects (6), whereas others have demonstrated a different pattern (16,34). Although elevated levels of both forms of BNP in HTN often have been attributed to the presence of LVH (17,23,35), no clear relationship between plasma BNP levels and blood pressure has been reported so far in patients with essential HTN.…”

Section: Discussionmentioning

confidence: 99%

Lack of activation of molecular forms of the BNP system in human grade 1 hypertension and relationship to cardiac hypertrophy

Belluardo¹,

Cataliotti²,

Bonaiuto³

et al. 2006

American Journal of Physiology-Heart and Circulatory Physiology

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. Lack of activation of molecular forms of the BNP system in human grade 1 hypertension and relationship to cardiac hypertrophy. Am J Physiol Heart Circ Physiol 291: H1529 -H1535, 2006. First published April 28, 2006 doi:10.1152/ajpheart.00107.2006.-We evaluated relationships among two circulating molecular forms of brain natriuretic peptide (BNP32 and NT-proBNP), severity of hypertension (HTN), and cardiac hypertrophy in subjects with mild, moderate, and severe HTN. We prospectively studied 78 patients (43 males; mean age 51.4 Ϯ 11 yr) with essential HTN and 28 age-and sex-matched controls. BNP32 and NT-proBNP were measured by radioimmunoassay. In grade 1 HTN, BNP32 was not elevated and NT-proBNP was reduced (P ϭ 0.030) compared with controls. However, log-transformed values of BNP32 and NT-proBNP were both increased with severity of HTN from grade 1 to 3 (P Ͻ0.0001 and P ϭ 0.003, respectively). By multivariate analysis, log BNP32 was independently predicted by age (␤ ϭ 0.210, P ϭ 0.026) and HTN grade (␤ ϭ 0.274, P ϭ 0.004), whereas log NT-proBNP was independently predicted by sex (␤ ϭ 0.235, P ϭ 0.012) and HTN grade (␤ ϭ 0.218, P ϭ 0.0023). Two forms of BNP were measured in normal subjects and patients with essential HTN. In grade 1 HTN, BNP32 was unchanged and NTproBNP was significantly reduced compared with controls. As severity increased in humans with grade 1 to 3 HTN, both BNP32 and NT-proBNP levels were increased while not being affected by the presence of left ventricular hypertrophy. The lack of activation of BNP32 together with the reduction of NT-proBNP in grade 1 HTN may represent an impaired response of the BNP system in the early phase of HTN. The later activation of both forms of BNP may be a late compensatory effect, because it correlates with severity of HTN rather than cardiac hypertrophy/remodeling. natriuretic peptide; brain natriuretic peptide; amino-terminal pro-brain natriuretic peptide; left ventricular hypertrophy BRAIN NATRIURETIC PEPTIDE (BNP) is synthesized in cardiac myocytes as the precursor proBNP, a 108-amino acid peptide (4, 27, 33), and is converted to biologically active peptide BNP32 via a proteolytic cleavage by corin, a type II transmembrane cardiac serine protease (22,38,39). BNP is present in the circulation in two different forms, the biologically active BNP32 that elicits different beneficial cardiorenal and hormonal actions (1,5,8,11,25,26,40) and the amino-terminal portion of BNP (NT-proBNP) that consists of 76 amino acids.In congestive heart failure (CHF) as well as in hypertension (HTN), ventricular cardiomyocytes are progressively recruited to synthesize BNP (24). Whereas initially a successful defensive endocrine response by the heart to preserve cardiorenal homeostasis might occur, a hyporesponsiveness to cardiac peptides, which might contribute in turn to the progression of hypertension, could follow later. Although BNP32 has emerged as an important diagnostic and prognostic biomarker of CHF (1, 12, 37), its levels are markedly variable in HTN. Therefore, its b...

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Low Atrial Natriuretic Peptide Plasma Concentrations in 100 Patients with Essential Hypertension

Cited by 10 publications

References 0 publications

Chronic Caffeine Ingest ion Exacerbates 2-Kidney, 1-Clip Hypertension and Ameliorates Deoxycorticosterone Acetate-Salt Hypertension in Rats

Chronic Caffeine Ingest ion Exacerbates 2-Kidney, 1-Clip Hypertension and Ameliorates Deoxycorticosterone Acetate-Salt Hypertension in Rats

Plasma Brain Natriuretic Peptide Levels and Blood Pressure Tracking in the Framingham Heart Study

Lack of activation of molecular forms of the BNP system in human grade 1 hypertension and relationship to cardiac hypertrophy

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