Orthostatic hypotension of unknown cause: Unanticipated association with elevated circulating N-terminal brain natriuretic peptide (NT-proBNP)

Elevated brain natriuretic peptide levels in chronic fatigue syndrome associate with cardiac dysfunction: a case control study

“…Another explanation is that the higher BNP levels are causing a diuresis (or natriuresis) and that this is depleting the plasma/blood volumes and leading to the smaller cardiac volumes. Studies from our group and others have shown smaller plasma volumes in CFS 6 7 and studies with patients with orthostatic hypotension have reported high BNP levels in some patients 18 and have been suggested as potentially causative.…”

B-type natriuretic peptide is upregulated by c-Jun N-terminal kinase and contributes to septic hypotension

“…Genetic ablation of the Nppb gene delays hypotension and increases cardiac preload. Previous studies have associated BNP with lower blood pressure (18,19) and have associated increased BNP with tissue hypoxia and mortality in septic patients (9). Furthermore, we previously showed that elevation in BNP following CLP precedes the onset of hypotension and occurs in coordination with reduced CO (13).…”

“…Previous studies have shown that transgenic mice overexpressing BNP have reduced resting blood pressure (19,26). Furthermore, aberrantly increased plasma BNP has been identified as a cause of orthostatic hypotension in patients (18). BNP acts on multiple organ systems to increase venous capacitance, increase natriuresis, and promote plasma shift, the combined effect of which is to reduce the return of blood to the heart.…”

Adrenomedullin and galanin responses to orthostasis in older persons

“…Future research should investigate the effects of orthostatic loading (HUT + LBNP vs. sit‐to‐stand test), time (across 1 year), ageing and gender on plasma concentrations of adrenomedullin, galanin and adrenocorticotropic hormone, brain natriuretic peptide and pituitary adenylate cyclase‐activating peptide, which also have blood pressure regulatory roles . In addition to hormonal responses, the modulation of endothelial function, cardiovascular autonomic function and cerebral blood flow should be assessed.…”