title: Natriuretic peptides and collagen biomarkers in patients with medical treatment for hypertension.
abstract: OBJECTIVE
  The Anglo-Scandinavian Cardiac Outcomes Trial (ASCOT-BPLA) showed that an amlodipine-based regimen prevented more cardiovascular events than an atenolol-based regimen in patients at high risk of hypertension.The basis of this difference is partly unknown and may be due to their divergent effects on the remodelling process of hypertensive heart disease.
  
  
  RESULTS
  We measured plasma levels of aminoterminal propeptide of atrial natriuretic peptide (NT-proANP) and aminoterminal propeptide of B-type natriuretic peptide and serum levels of the aminoterminal propeptide of type I procollagen (PINP), aminoterminal propeptide of type III procollagen and type I collagen telopeptide in 93 patients randomized in the ASCOT study at baseline and after two and four years and compared them with echocardiographic parameters and blood pressure. NT-proANP decreased at two years by 22 (-484 - 153) pmol/l in the amlodipine-based regimen and increased by 109 (-297 - 1545) pmol/l in the atenolol-based regimen (P < 0.001), whereas no significant difference in NT-proBNP between the arms was found. PINP levels increased by 1.8 (-29 -31) microg/l in the amlodipine-based regimen and decreased by 4.7 (-27- 31) microg/I in the atenolol-based regimen, whereas no differences were found in other collagen markers between the arms. Major echocardiographic changes were not found.
  
  
  CONCLUSIONS
  Our results show that the two treatment regimens of ASCOT-BPLA had different effects on plasma natriuretic peptides and serological markers of collagen turnover, probably reflecting divergent effects in cardiac remodelling.
authors: Institute of Clinical Medicine, Department of Internal Medicine, University of Oulu, Finland. paavo.uusimaa@oulu.fi
authors: Paavo
authors: P
authors: Uusimaa
authors: Sini
authors: S
authors: Peuhkurinen
authors: Antti
authors: A
authors: Ylitalo
authors: Olli
authors: O
authors: Vuolteenaho
authors: Juha
authors: J
authors: Risteli
authors: Keijo
authors: K
authors: Peuhkurinen
mesh_terms: D017311:Amlodipine / Q000627:therapeutic use*; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D001262:Atenolol / Q000627:therapeutic use*; D009320:Atrial Natriuretic Factor / Q000097:blood* / Q000187:drug effects; D015415:Biomarkers / Q000097:blood*; D003094:Collagen / Q000378:metabolism*; D024042:Collagen Type I; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D020097:Natriuretic Peptide, Brain / Q000097:blood; D010446:Peptide Fragments / Q000097:blood / Q000187:drug effects; D010455:Peptides; D011347:Procollagen / Q000097:blood / Q000187:drug effects; D020257:Ventricular Remodeling / Q000187:drug effects* / Q000502:physiology
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers; D024042:Collagen Type I; D010446:Peptide Fragments; D010455:Peptides; D011347:Procollagen; C052929:collagen type I trimeric cross-linked peptide; C109794:pro-brain natriuretic peptide (1-76); C047202:procollagen Type I N-terminal peptide; C041876:procollagen Type III-N-terminal peptide; D020097:Natriuretic Peptide, Brain; D017311:Amlodipine; D001262:Atenolol; D009320:Atrial Natriuretic Factor; D003094:Collagen