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Atrial natriuretic peptide in patients with essential hypertension. Hemodynamic, renal, and hormonal responses
H G Predel1, O Schulte-Vels, K Glänzer
1Medizinische Poliklinik, University of Bonn, Germany.
Insights
Human atrial natriuretic peptide (alpha-hANP) infusion lowered blood pressure in patients with essential hypertension and healthy volunteers. The natriuretic and diuretic effects were more pronounced in hypertensive patients, suggesting potential therapeutic benefits.
Area of Science:
- Cardiology
- Nephrology
- Endocrinology
Background:
- Essential hypertension (EH) is a condition characterized by elevated blood pressure.
- Atrial natriuretic peptide (ANP) plays a role in regulating blood pressure and fluid balance.
- Basal plasma ANP levels are often elevated in patients with essential hypertension.
Purpose of the Study:
- To investigate the effects of human atrial natriuretic peptide (alpha-hANP) on systemic and renal hemodynamics in patients with essential hypertension.
- To compare the renal excretory function response to alpha-hANP in hypertensive patients versus healthy controls.
Main Methods:
- A 60-minute intravenous infusion of alpha-hANP (24 ng/min/kg) was administered to six patients with EH and six healthy volunteers.
- Systemic hemodynamics (blood pressure, cardiac output, heart rate) and renal excretory function (urine flow, urinary sodium excretion) were monitored.
- Basal plasma ANP concentrations were measured in both groups.
Main Results:
- Alpha-hANP infusion led to a significant decrease in blood pressure in both EH patients and healthy controls.
- Cardiac output showed a transient increase, while heart rate remained unchanged.
- The increases in urine flow and urinary sodium excretion were significantly more pronounced in patients with EH compared to controls.
Conclusions:
- Intravenous alpha-hANP effectively reduces blood pressure in individuals with essential hypertension.
- Hypertensive patients exhibit an enhanced natriuretic and diuretic response to alpha-hANP, indicating potential therapeutic value.
- These findings suggest that alpha-hANP may be a promising agent for managing essential hypertension.
Abstract:
In six patients with essential hypertension (EH) and in six healthy volunteers (C) the effects of a 60-min intravenous (iv) infusion of human atrial natriuretic peptide (alpha-hANP) (24 ng/min/kg) on systemic and renal hemodynamics and renal excretory function were evaluated. Basal plasma ANP concentrations in patients with EH were higher (P less than .05) than in C (30.9 +/- 4.5 v14.0 +/- 1.7 pmol/L). Maximal effects of alpha-hANP infusion occurred after 30 to 60 min. Blood pressure (BP) declined from 154 +/- 5/109 +/- 4 to 139 +/- 7/94 +/- 4 in EH and from 117 +/- 1/72 +/- 2 to 106 +/- 1/65 +/- 3 mm Hg in C (P less than .05). Cardiac output (CO) increased transiently from 6.1 +/- 0.3 to 6.5 +/- 0.4 L/min in EH and from 6.8 +/- 0.3 to 7.2 +/- 0.5 L/min in C, whereas heart rate (HR) remained constant both in patients with EH and in C (69 +/- 3 to 72 +/- 5 and 60 +/- 3 to 63 +/- 3/min). The increases in urine flow and in urinary sodium excretion from 3.6 +/- 0.2 to 16.0 +/- 2.0 mL/min and from 230 +/- 33 to 1004 +/- 137 mumol/min, respectively, in EH were more pronounced than in C (from 3.9 +/- 1.0 to 8.4 +/- 0.8 mL/min and from 211 +/- 37 to 451 +/- 84 mumol/min); (P less than .05).(ABSTRACT TRUNCATED AT 250 WORDS)