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Plasma concentrations of atrial natriuretic peptide in children with persistent hypertension
Insights
In older children, elevated plasma human atrial natriuretic peptide (hANP) levels are linked to persistent hypertension. This peptide may aid sodium regulation in normotensive adolescents but not in hypertensive ones.
Area of Science:
- Pediatric Nephrology
- Cardiovascular Physiology
- Endocrinology
Background:
- Persistent hypertension in children is a growing concern.
- Human atrial natriuretic peptide (hANP) plays a role in regulating blood pressure and sodium balance.
- Understanding hANP levels in pediatric hypertension is crucial for identifying potential biomarkers and therapeutic targets.
Purpose of the Study:
- To investigate plasma concentrations of hANP in children with persistent hypertension compared to normotensive controls.
- To explore the relationship between hANP levels, sodium excretion, and hypertension in different age groups of children.
Main Methods:
- Plasma hANP levels were measured in two age groups of children: 6-7 years (Group A) and 13-14 years (Group B).
- Participants were categorized into hypertensive and normotensive groups.
- 24-hour urinary sodium excretion and fractional excretion of sodium were assessed in Group B.
Main Results:
- No significant difference in plasma hANP was found between hypertensive and normotensive children in Group A (younger children).
- In Group B (adolescents), plasma hANP was significantly higher in hypertensives (86.5 +/- 44.9 pg/ml) than in normotensives (58.8 +/- 40.4 pg/ml) (p < 0.01).
- In normotensive adolescents, plasma hANP correlated with sodium excretion, but this correlation was absent in hypertensive adolescents.
Conclusions:
- Elevated plasma hANP in older children with hypertension suggests a potential role in the condition's pathophysiology.
- hANP may be involved in sodium homeostasis regulation in normotensive adolescents.
- Alternative regulatory mechanisms for sodium handling might be involved in hypertensive adolescents.
Abstract:
Plasma concentrations of human atrial natriuretic peptide (hANP) were determined in children with persistent hypertension and in age-matched normotensive controls. We studied 40 children 6-7 years of age (Group A), and 74 children 13-14 years of age (Group B). There was no significant difference in plasma hANP concentration between hypertensives and normotensives in group A. In group B, the plasma hANP concentration in hypertensives (86.5 +/- 44.9 pg/ml: mean +/- SD) was significantly higher than in normotensives (58.8 +/- 40.4 pg/ml) (p less than 0.01). In group B, 24-hour urinary excretion of sodium and fractional excretion of sodium were not significantly different between hypertensives and normotensives. The plasma hANP correlated significantly with the fractional excretion of sodium (p less than 0.05) and the 24-hour urinary excretion of sodium (p less than 0.01) in normotensives. No such correlation was evident in the case of the hypertensives. The pathogenesis of increased plasma hANP concentration in older children with persistent hypertension remains to be investigated. In regard to the effects of hANP on renal function, hANP may contribute to the regulation of sodium handling in normotensive adolescents, whereas other regulatory mechanisms need to be considered in the case of hypertensives.