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Developing essential hypertension: a syndrome involving ANF deficiency?
P Weidmann1, P Ferrari, Y Allemann
1Medizinische Poliklinik, University of Berne, Switzerland.
Canadian Journal of Physiology and Pharmacology
|October 1, 1991
Summary
Essential hypertension may involve atrial natriuretic factor (ANF) deficiency. Offspring of hypertensive parents show impaired ANF response to salt, suggesting early pathway disturbance. This may predispose to hypertension development.
Area of Science:
- Cardiology
- Nephrology
- Endocrinology
Background:
- Essential hypertension pathogenesis may involve endogenous vasodilator and natriuretic factors.
- Offspring of hypertensive parents (OHyp) may exhibit prehypertension and altered BP regulation.
- Atrial natriuretic factor (ANF) is a key regulator of BP and natriuresis.
Purpose of the Study:
- To investigate hereditary defects in blood pressure regulating factors in normotensive offspring of hypertensive parents (OHyp).
- To evaluate the role of atrial natriuretic factor (ANF) and its second messenger, cyclic GMP, in hypertension development.
- To explore the potential of ANF system activation as a therapeutic strategy for essential hypertension.
Main Methods:
- Comparison of plasma ANF levels and cyclic GMP in OHyp versus healthy offspring on varying salt intakes.
- Assessment of renal excretory responses to ANF infusion in OHyp.
- Measurement of plasma ANF levels in patients with uncomplicated essential hypertension and those with cardiac complications.
Main Results:
- OHyp showed unaltered plasma ANF on low salt but impaired response to high salt intake compared to controls.
- Plasma cyclic GMP levels tended to be decreased in some OHyp.
- Renal responses to ANF infusion were unchanged in tested OHyp, suggesting a circulatory-level disturbance.
- Plasma ANF levels in uncomplicated essential hypertension were often "normal" but potentially inappropriately low relative to BP.
- ANF infusion in hypertensive patients produced exaggerated natriuresis and lowered BP.
Conclusions:
- A syndrome of ANF deficiency, characterized by impaired ANF response to salt and low cyclic GMP, is postulated in hypertension-prone individuals.
- Disturbances in the ANF-cyclic GMP pathway may manifest at the circulatory level in prehypertension.
- Relative ANF deficiency and enhanced natriuretic response to ANF support ANF system activation as a treatment for essential hypertension.