Enhanced secretion and impaired natriuretic action of atrial natriuretic peptide in response to hypertonic saline infusion in patients with essential hypertension.
To clarify the natriuretic action of endogenous atrial natriuretic peptide (ANP) in patients with essential hypertension (EHT), we examined the relationship between ANP release and urinary sodium excretion in response to hypertonic saline infusion. Plasma ANP levels increased from 13.3 +/- 2.0 pg/ml to 37.0 +/- 3.0 pg/ml in patients with EHT and from 9.2 +/- 1.5 pg/ml to 21.1 +/- 4.0 pg/ml in normal subjects after the infusion. The area under the curve (AUC) of plasma ANP response was significantly higher in patients with EHT than in normal subjects (P < 0.05). There was a significant positive correlation between AUC and urinary sodium excretion in both groups (P < 0.01). However, the ratio of urinary sodium excretion to AUC was significantly lower in patients with EHT than in normal subjects (P < 0.01). These results suggest that impaired natriuretic response to endogenous ANP is one of the factors responsible for the development of EHT and that enhanced secretion of ANP in response to hypertonic saline infusion is a compensatory mechanism to the impaired natriuretic action of ANP in patients with EHT.
Akaike
M
M
First Department of Internal Medicine, School of Medicine, University of Tokushima, Japan.
Nishiuchi
T
T
Matsumoto
N
N
Kawai
H
H
Saito
S
S
D000328:Adult; D000368:Aged; D009320:Atrial Natriuretic Factor / Q000097:blood / Q000378:metabolism*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009318:Natriuresis / Q000187:drug effects*; D012462:Saline Solution, Hypertonic / Q000494:pharmacology*
D012462:Saline Solution, Hypertonic; D009320:Atrial Natriuretic Factor