Vascular actions of natriuretic peptides. Cyclic GMP-dependent and -independent mechanisms

Natriuretic peptides play important roles in the regulation of cardiovascular homeostasis. The endocrine actions of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) complement the paracrine effects of C-type natriuretic peptide (CNP) and urodilatin to regulate vascular smooth muscle tone, fluid and electrolyte balance and cardiac morphology. As a consequence, aberrant natriuretic peptide production and/or activity have been linked to a number of cardiovascular disorders and interventions that selectively modulate these vasoactive peptides may be of therapeutic benefit. This review will outline the structure, expression and vascular actions of natriuretic peptides and their endogenous receptors and highlight recent work that has revealed important interactions between the cyclic GMP producing particulate and soluble guanylate cyclases, thereby linking the cardiovascular actions of natriuretic peptides and nitric oxide, and a role for CNP as an endothelium-derived hyperpolarising factor (EDHF).