[Atrial natriuretic peptide (ANP) in essential hypertension: a humoral marker for salt sensitivity and hypertensive heart disease at a clinically asymptomatic stage?].
Out of 32 patients (f = 10, m = 22; mean age: 46 +/- 3 years) with untreated essential (primary) hypertension (WHO-classification I-III) and without clinical signs of congestive heart failure or chronic renal failure, 19 showed plasma-ANP base levels above the normal range (greater than 100 pg/ml; normal range: 50 +/- 10 pg/ml). While high sodium loading caused an increase of plasma ANP levels and a concomitant decrease of plasma renin and aldosterone concentrations, low sodium loading caused the opposite pattern of ANP and renin/aldosterone secretion. Some patients with essential hypertension with highly elevated plasma ANP levels (10-20-fold above the normal range) showed an only moderate decrease of ANP and a slight increase of renin under a low sodium diet. Plasma ANP levels were significantly correlated with the heart volume (r = 0.54; p less than 0.05; radiologically determined), the electrocardiographic signs of left ventricular hypertrophy (Sokolow-Lyon index; r = 0.62; p less than 0.05) and with the left atrial diameter (r = 0.34; p less than 0.05; determined by 2-D-echocardiography). We speculate that high levels of plasma ANP in patients with essential hypertension might be interpreted as a compensatory mechanism either for an insufficient excretion of sodium or for myocardial dysfunction.
Stimpel
M
M
Medizinische Klinik II, Universität Köln, Krankenanstalten Köln-Merheim.
Kaufmann
W
W
Wambach
G
G
D000328:Adult; D000450:Aldosterone / Q000097:blood / Q000652:urine; D009320:Atrial Natriuretic Factor / Q000097:blood*; D001794:Blood Pressure; D002395:Catecholamines / Q000652:urine; D005260:Female; D006331:Heart Diseases / Q000097:blood* / Q000503:physiopathology / Q000652:urine; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000652:urine; D006973:Hypertension / Q000097:blood* / Q000503:physiopathology / Q000652:urine; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012083:Renin / Q000097:blood; D012964:Sodium
D002395:Catecholamines; D000450:Aldosterone; D009320:Atrial Natriuretic Factor; D012964:Sodium; D012083:Renin; D006854:Hydrocortisone
Atriales natriuretisches Peptid (ANP) bei essentieller Hypertonie: Humoraler Marker für Kochsalzsensitivität und hypertensive Herzkrankheit im klinisch-asymptomatischen Stadium?