Brain Natriuretic Peptide Counteracting the Renin-angiotensin-aldosterone System in Accelerated Malignant Hypertension

We describe 2 patients, a 52-year-old woman and a 57-year-old man, with rapidly progressive hypertension and marked elevation of brain natriuretic peptide who exhibited polyuria, natriuresis, hypokalemia, posterior reversible encephalopathy syndrome and left ventricular dysfunction together with ret...

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Bibliographic Details
Published inThe American journal of the medical sciences Vol. 352; no. 5; p. 534
Main Authors Nakagawa, Hitoshi, Mizuno, Yuji, Harada, Eisaku, Morikawa, Yoshinobu, Kuwahara, Koichiro, Saito, Yoshihiko, Yasue, Hirofumi
Format Journal Article
LanguageEnglish
Published United States 01.11.2016
Subjects
Antihypertensive Agents - therapeutic use
Female
Humans
Hypertension, Malignant - blood
Hypertension, Malignant - drug therapy
Hypertension, Malignant - etiology
Male
Middle Aged
Natriuretic Peptide, Brain - blood
Renin-Angiotensin System
Hypokalemia
Brain natriuretic peptide
Renin-angiotensin-aldosterone system
Accelerated malignant hypertension
Polyuria
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Summary:We describe 2 patients, a 52-year-old woman and a 57-year-old man, with rapidly progressive hypertension and marked elevation of brain natriuretic peptide who exhibited polyuria, natriuresis, hypokalemia, posterior reversible encephalopathy syndrome and left ventricular dysfunction together with retinopathy and nephropathy, which were attenuated in a short time span of 1-2 months with normalization of blood pressure after the antihypertensive treatment. The possible role of brain natriuretic peptide in the pathophysiology of accelerated malignant hypertension was discussed and a review of the literature was completed.
ISSN:1538-2990
DOI:10.1016/j.amjms.2016.08.001