title: Antihypertensive therapy reduces increased plasma levels of adrenomedullin and brain natriuretic peptide concomitant with regression of left ventricular hypertrophy in a patient with malignant hypertension.
abstract: We investigated the potential role of increased plasma adrenomedullin and brain natriuretic peptide (BNP) levels in a patient with malignant hypertension. A 51-year-old man was admitted to our hospital with a chief complaint of visual disturbance. His blood pressure was 270/160 mmHg on admission. Papillary edema associated with retinal bleeding was observed. Echocardiography revealed marked concentric left ventricular hypertrophy with mild systolic dysfunction. Plasma levels of adrenomedullin and BNP were markedly elevated. Antihypertensive therapy reduced the plasma levels of adrenomedullin in association with a concomitant decrease in blood pressure. The plasma level of BNP also decreased and regression of left ventricular hypertrophy and normalization of left ventricular systolic function were observed. Our findings suggest that adrenomedullin may be involved in the defense mechanism against further elevations in blood pressure in patients with hypertension and that the plasma level of BNP may reflect left ventricular systolic dysfunction, left ventricular hypertrophy, or both, in patients with severe hypertension.
authors.affiliation: Division of Hypertension and Nephrology, National Cardiovascular Center Suita, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Nishikimi
authors.forename: H
authors.initials: H
authors.lastname: Matsuoka
authors.forename: K
authors.initials: K
authors.lastname: Ishikawa
authors.forename: F
authors.initials: F
authors.lastname: Yoshihara
authors.forename: Y
authors.initials: Y
authors.lastname: Kawano
authors.forename: K
authors.initials: K
authors.lastname: Kitamura
authors.forename: Y
authors.initials: Y
authors.lastname: Saito
authors.forename: K
authors.initials: K
authors.lastname: Kangawa
authors.forename: H
authors.initials: H
authors.lastname: Matsuo
authors.forename: T
authors.initials: T
authors.lastname: Omae
mesh_terms: D053607:Adrenomedullin; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000188:drug therapy; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D004452:Echocardiography; D004562:Electrocardiography / Q000187:drug effects; D004656:Enalapril / Q000627:therapeutic use*; D006801:Humans; D006974:Hypertension, Malignant / Q000188:drug therapy*; D017379:Hypertrophy, Left Ventricular / Q000000981:diagnostic imaging / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009529:Nicardipine / Q000627:therapeutic use; D010455:Peptides / Q000097:blood*; D014786:Vision Disorders / Q000188:drug therapy
chemical_list: D000959:Antihypertensive Agents; D010455:Peptides; D020097:Natriuretic Peptide, Brain; D053607:Adrenomedullin; D004656:Enalapril; D009529:Nicardipine