Plasma atrial natriuretic peptide levels in essential hypertension after treatment with verapamil

Kokkas, B.; Kotridis, P.; Karamouzis, M.; Kanonidis, Ioannis; Sakadamis, G.; Dadous, George; Haritos, S.; Kyriakoui, P.; Theodossiadis,; Papadopoulos, Pavlos; Mirtsou‐Fidani, V.; Papadopoulos, C.

doi:10.1007/bf03190404

Cited by 6 publications

(3 citation statements)

References 18 publications

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“…This conclusion is in accordance with our previous observations on humans with older~-adrenergic blockers (1-4) as well as those of other researchers (6)(7)(8)(9)(13)(14)(15). Experiments performed in cell cultures have also demonstrated the adrenergic influence of ANP secretion by the atria (16).…”

Section: Discussionsupporting

confidence: 93%

Carvedilol Increases Atrial Natriuretic Peptide Plasma Levels in Hypertensive Patients

Papadopoulos¹,

Kotridis²,

Kokkas

et al. 2007

Eur J Inflamm

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Twenty five patients with moderate essential hypertension were studied for 30 days in order to evaluate the medium term effects of carvedilol on atrial natriuretic peptide (ANP) levels. This drug blocks the III and 11 2 adrenenergic receptors as well as III adrenergic receptors. In addition, it has strong antioxidative and antiproliferative properties. The drug was given orally at a dose of 12.5 mg b.i.d, Quantitative determination of human ANP was made by radioimmunoassay procedure (RIA). At the end of this clinical trial, mean plasma levels of ANP had risen during treatment by 21.18% (from 37.60 pg/ml to 45.83 pg/ml) while both systolic (SBP) and diastolic (DBP) blood pressure as well as diameters of the left cardiac cavities had decreased in a statistically significant way. The ratio ANP/SBP was also increased by 46.6% in a statistically significant way. These findings support the suggestion that the increase in plasma ANP following the administration of Il-adrenergic blockers to hypertensive patients is a primary effect of beta blockade and not a mechanical one secondary to a negative inotropic action on the left ventricle and obviously contributes to the anti-hypertensive action.Major interest has been focused upon the investigation of unconventional methods of the anti-hypertensive action of drugs used for the treatment of arterial hypertension. A strong motive for the interest in this particular subject is derived from the fact that no conventional hemodynamic effect can provide a satisfactory explanation for the chronic long-term anti-hypertensive efficacy of p-adrenergic blockers. The investigation, which was conducted by the research group of the 2 nd Department of Cardiology with the cooperation of the Departments of Pharmacology and Biochemistry at the Medical School of the Aristotle University of Thessaloniki, resulted in a number of presentations and publications in Greece and abroad. According to the investigation, ANP seems to be an important mediator between the p-adrenergic blockers and the therapy of arterial hypertension. Since then, interest has been expanded to investigate other antihypertensive agents and their linkage to ANP and the results of such investigation have been confirmative (1-4).Subsequently, it sounded reasonable to investigate a possible role of ANP upon the anti-hypertensive

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Section: Discussionsupporting

confidence: 93%

Carvedilol Increases Atrial Natriuretic Peptide Plasma Levels in Hypertensive Patients

Papadopoulos¹,

Kotridis²,

Kokkas

et al. 2007

Eur J Inflamm

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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: 84%

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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“…This is a very important finding because the relation between the plasma levels of ANP and the systolic blood pressure rate reflects mechanisms of the antihypertensive action of the drug after a medium term treatment. Nebivolol follows the same rule as~ adrenergic blockers of older generation as well as antihypertensive drugs of other classes (3)(4)(5)(6)(8)(9)(10)(11)(12)(13)(14)(15).…”

Section: Discussionmentioning

confidence: 99%

Nebivolol Increases Atrial Natriuretic Peptide/Systolic Blood Pressure Ratio in Hypertensive Patients

et al. 2008

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The aim of this study is to evaluate the medium term treatment effects of the beta-blocker nebivolol on the endogenous anti-hypertensive and anti-inflammatory agent Atrial Natriuretic Peptide (ANP) plasma levels in patients with moderate uncomplicated essential hypertension. The drug was given orally for 30 days to 25 patients. The daily dose was 5 mg once every morning. Quantitative determination of ANP was made by Radioimmunoassay (RIA). At the end of this clinical trial, plasma ANP levels showed a statistically non significant tendency to increase by 10.99% while both systolic (SBP) and diastolic (DBP) blood pressure as well as the diameters ofthe left cardiac cavities showed a statistically significant decrease. What was interesting was the fact that there was a statistically significant increase of 44.7% in the ratio ANP/SBP following the reduction of arterial blood pressure. This increase was the most important and essential finding as it indicated a real increase of ANP plasma levels. This result was obtained even though pressure and afterload, the homologous mechanical stimulatory parameters for ANP secretion, of the left cavities were diminished. These findings provide strong indications which were supported by several previous trials, that the increase in plasma ANP following the administration of beta-adrenergic blockers to hypertensive patients was a primary effect of beta blockade and not a mechanical one secondary to a negative inotropic action on the left ventricle. This primary action contributed to the anti-hypertensive effect of nebivolol during this trial.It is known that the short-term effect of antihypertensive drugs is due to their action on cardiac output and/or peripheral resistance. However, their long-term effect is due to changes in the pressure/natriuresis relationship. No conventional hemodynamic effect can provide a satisfactory explanation for the chronic long-term antihypertensive efficacy of p-adrenergic blockers.Thus, it is quite reasonable to try to explain the effects of the above drugs on the arterial pressure by evaluating their action on factors that control pressure-natriuresis. Such a factor is Atrial Natriuretic Peptide (ANP) which also possesses antiinflammatory properties (1). Furthermore, the links between inflammation and cardiovascular diseases, especially hypertension, are well documented (2).

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Plasma atrial natriuretic peptide levels in essential hypertension after treatment with verapamil

Cited by 6 publications

References 18 publications

Carvedilol Increases Atrial Natriuretic Peptide Plasma Levels in Hypertensive Patients

Carvedilol Increases Atrial Natriuretic Peptide Plasma Levels in Hypertensive Patients

Atrial natriuretic peptide contributes to the antihypertensive action of many drugs

Nebivolol Increases Atrial Natriuretic Peptide/Systolic Blood Pressure Ratio in Hypertensive Patients

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