title: Brain Natriuretic Peptide Counteracting the Renin-angiotensin-aldosterone System in Accelerated Malignant Hypertension.
abstract: We describe 2 patients, a 52-year-old woman and a 57-year-old man, with rapidly progressive hypertension and marked elevation of brain natriuretic peptide who exhibited polyuria, natriuresis, hypokalemia, posterior reversible encephalopathy syndrome and left ventricular dysfunction together with retinopathy and nephropathy, which were attenuated in a short time span of 1-2 months with normalization of blood pressure after the antihypertensive treatment. The possible role of brain natriuretic peptide in the pathophysiology of accelerated malignant hypertension was discussed and a review of the literature was completed.
authors.affiliation: Division of Cardiovascular Medicine, Kumamoto Kinoh Hospital, Kumamoto Aging Research Institute, Kumamoto, Japan; First Department of Internal Medicine, Nara Medical University, Kashihara, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Nakagawa
authors.affiliation: Division of Cardiovascular Medicine, Kumamoto Kinoh Hospital, Kumamoto Aging Research Institute, Kumamoto, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Mizuno
authors.affiliation: Division of Cardiovascular Medicine, Kumamoto Kinoh Hospital, Kumamoto Aging Research Institute, Kumamoto, Japan.
authors.forename: Eisaku
authors.initials: E
authors.lastname: Harada
authors.affiliation: Division of Cardiovascular Medicine, Kumamoto Kinoh Hospital, Kumamoto Aging Research Institute, Kumamoto, Japan; First Department of Internal Medicine, Nara Medical University, Kashihara, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Morikawa
authors.affiliation: Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Kuwahara
authors.affiliation: First Department of Internal Medicine, Nara Medical University, Kashihara, Japan.
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Saito
authors.affiliation: Division of Cardiovascular Medicine, Kumamoto Kinoh Hospital, Kumamoto Aging Research Institute, Kumamoto, Japan. Electronic address: yasue@juryo.or.jp.
authors.forename: Hirofumi
authors.initials: H
authors.lastname: Yasue
mesh_terms: D000959:Antihypertensive Agents / Q000627:therapeutic use; D005260:Female; D006801:Humans; D006974:Hypertension, Malignant / Q000097:blood* / Q000188:drug therapy / Q000209:etiology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D012084:Renin-Angiotensin System
chemical_list: D000959:Antihypertensive Agents; D020097:Natriuretic Peptide, Brain
keywords: Accelerated malignant hypertension; Brain natriuretic peptide; Hypokalemia; Polyuria; Renin-angiotensin-aldosterone system