Atrial Natriuretic Peptide in Non-modulating Essential Hypertension

• Published in: Hypertension (Dallas, Tex. 1979) Vol. 21; no. 6, Part 1; pp. 803 - 809
• Main Authors: Luparini, Riccardo Leonetti, Ferri, Claudio, Santucci, Anna, Balsano, Francesco
• Format: Journal Article
• Language: English
• Published: Philadelphia, PA American Heart Association, Inc 01.06.1993; Hagerstown, MD Lippincott
• Subjects: Adult; Aldosterone - blood; Angiotensin II - pharmacology; Arterial hypertension. Arterial hypotension; Atrial Natriuretic Factor - blood; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Clinical manifestations. Epidemiology. Investigative techniques. Etiology; Diet, Sodium-Restricted; Hormones - blood; Humans; Hypertension - blood; Kidney - drug effects; Male; Medical sciences; Middle Aged; p-Aminohippuric Acid - blood; Renin - blood; Sodium - administration & dosage; Sodium - pharmacology; Human; Hypertension; Renin angiotensin system; Natriuretic hormone; Modulation; Peptide hormone; Cardiovascular disease; Adult; Exploration; Atrial natriuretic peptide; Angiotensin II; Essential
• ISSN: 0194-911X; 1524-4563
• DOI: 10.1161/01.HYP.21.6.803

To evaluate the atrial natriuretic peptide response to angiotensin II (Ang II) infusion in non-modulating hypertension, we studied 31 men with essential hypertension. These patients were subdivided into groups of low renin patients (n=8), non-modulators (n=11), and modulators (n=12) according to their renin profile and ability to modulate renin and aldosterone responses to a graded infusion of Ang II (1.0 and 3.0 ng/kg per minute) on a low Na intake (10 mmol Na per day). During basal conditions, plasma atrial natriuretic peptide was higher (p<0.05) in low renin patients (1634±2.67 fmol/mL) than in both modulators (10.59±4.29 fmol/mL) and non-modulators (9.85±2.64 fmol/mL). During Ang II infusion, plasma atrial natriuretic peptide significantly increased in both low renin (27.67±2.61 fmol/mL at 60 minutes, p<0.01) and modulating (20.36±3.07 fmol/mL at 60 minutes, p<0.05) patients, whereas it did not change in non-modulators (13.94±439 fmol/mL, NS). After 5 days on a high sodium intake (200 mmol Na per day), plasma atrial natriuretic peptide rose in modulating (20.61±2.3l fmol/mL, p<0.01 versus low sodium intake), non-modulating (20.11±6.48 fmol/mL, p<0.01 versus low sodium intake), and low renin (26.13±3.81 fmol/mL, p<0.001 versus low sodium intake) hypertensive patients. When the Ang II infusion was repeated with a high sodium intake, plasma atrial natriuretic peptide increased again in low renin and modulating patients, whereas it did not change in non-modulators. Therefore, these data indicate that an impaired atrial natriuretic peptide responsiveness to Ang II that is not dependent on Na intake may represent another characteristic of the non-modulating phenotype.