Atrial natriuretic peptides in essential hypertension: basal plasma levels and relationship to sodium balance

1991 ◽  
Vol 69 (10) ◽  
pp. 1592-1600 ◽  
Author(s):  
G. A. Sagnella ◽  
N. D. Markandu ◽  
M. G. Buckley ◽  
M. A. Miller ◽  
D. R. J. Singer ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Natriuretic Peptides ◽  
Renin Angiotensin System ◽  
Dietary Sodium ◽  
Sodium Balance ◽  
Potential Importance ◽  
Atrial Natriuretic Peptides ◽  
Angiotensin System ◽  
Renin Angiotensin ◽  
Atrial Natriuretic

The identification of the atrial natriuretic peptides (ANP) as a new hormonal system has provided a new perspective on the mechanisms controlling renal sodium excretion and abnormalities in sodium homeostasis. The present article focuses on the potential importance of ANP (ANF 99–126) in essential hypertension with particular reference to circulating ANP levels and the relationship between the ANP and the renin–angiotensin system in the control of sodium balance and blood pressure. There is now considerable evidence demonstrating that a substantial proportion of patients with essential hypertension have raised circulating ANP levels. Given the known biological actions of ANP, these raised levels point to important compensatory mechanisms. This is further supported by studies during alterations in dietary sodium intake, as sodium restriction highlighted important relationships between ANP and the renin angiotensin system. The potential importance of ANP in essential hypertension is strengthened by recent demonstration of natriuretic and antihypertensive actions associated with small increases in circulating ANP as induced by administration of exogenous ANP. Furthermore, the recent development of orally active inhibitors of ANP metabolism now provides a basis to determine the therapeutic importance of specific manipulation of endogenous ANP levels in patients with essential hypertension.Key words: ANF, essential hypertension, sodium balance.

Atrial natriuretic peptides – diagnostic and therapeutic potential

2000 ◽  
Vol 57 (5) ◽  
pp. 305-312
Author(s):  
Brockhoff ◽  
Warnholtz ◽  
Münzel
Keyword(s):  
Natriuretic Peptides ◽  
Therapeutic Potential ◽  
Renin Angiotensin System ◽  
Atrial Natriuretic Peptides ◽  
Angiotensin System ◽  
Renin Angiotensin ◽  
Atrial Natriuretic

Die Familie der natriuretischen Peptide besteht aus insgesamt drei Peptiden, die große Übereinstimmung in Bezug auf die Aminosäuresequenzen und eine Schleife in ihrer Struktur besitzen. Das Atriale Natriuretische Peptid (ANP) und das Brain Natriuretische Peptid (BNP) wirken diuretisch, natriuretisch und vasodilatierend und besitzen wichtige antagonisierende Wirkungen in Bezug auf das Renin-Angiotensin-System. Das CNP hingegen ist weit weniger gut charakterisiert und besitzt im Gegensatz zu ANP und BNP nur vasodilatierende und keine diuretischen Eigenschaften. Die Plasmaspiegel von ANP und BNP sind bei Patienten mit instabiler AP-Symptomatik, akutem Myokardinfarkt und chronischer Herzinsuffizienz erhöht. Aufgrund der bisherigen Untersuchungen besitzt das BNP und nicht das ANP möglicherweise eine gewisse Bedeutung als Prognosefaktor bei Patienten nach Herzinfarkt und bei Patienten mit Herzinsuffizienz. Während die Peptide selbst nur eine geringe Bedeutung in der Therapie der koronaren Herzkrankheit oder Herzinsuffizienz besitzen, scheinen Inhibitoren des ANP-Metabolismus insbesondere in der Kombination mit ACE-Hemmern den klinischen Verlauf positiv beeinflussen zu können.

Studies on the Renin-Angiotensin System in a Kininogen-Deficient Individual

1983 ◽  
Vol 65 (2) ◽  
pp. 121-126 ◽  
Author(s):  
Patrick Y. Wong ◽  
Gordon H. Williams ◽  
Robert W. Colman
Keyword(s):  
Angiotensin Ii ◽  
Plasma Renin Activity ◽  
Renin Angiotensin System ◽  
Plasma Renin ◽  
Renin Activity ◽  
Dietary Sodium ◽  
Sodium Balance ◽  
Angiotensin System ◽  
Renin Angiotensin ◽  
Normal Individuals

1. The physiological responses of the renin-angiotensin system were studied in an individual with kininogen deficiency (patient 1) with absent plasma bradykinin and markedly impaired prekallikrein conversion into kallikrein. After sodium depletion, patient 1 had a low plasma renin activity (1.4 pmol of ANG I h−1 ml−1) and a low angiotensin II concentration (36 pg/ml) compared with values in 11 normal individuals (4.0 ± 0.94 pmol of ANG I h−1 ml−1) and 63 ±6 pg/ml respectively). 2. Unlike normal individuals, in the kininogen-deficient subject there was no significant fall of renin activity or angiotensin II after dietary sodium repletion. Intravenous sodium repletion also failed to further decrease plasma renin activity or angiotensin II. 3. The usual two- to three-fold rise in plasma renin activity and angiotensin II observed in normal subjects on assumption of the upright posture after ingestion of 200 mg of sodium/day failed to occur in the kininogen-deficient individual. 4. These data in vivo are in agreement with observations in vitro that once plasma kallikrein forms it may be important in converting prorenin into renin. In the absence of kininogen, activation of prekallikrein to kallikrein is grossly defective, which may in part account for the diminished response of the renin-angiotensin system to changes in sodium balance and posture.

Diurnal change in plasma atrial natriuretic peptide concentrations

1987 ◽  
Vol 73 (5) ◽  
pp. 489-495 ◽  
Author(s):  
A. M. Richards ◽  
G. Tonolo ◽  
R. Fraser ◽  
J. J. Morton ◽  
B. J. Leckie ◽  
...  
Keyword(s):  
Angiotensin Ii ◽  
Atrial Natriuretic Peptide ◽  
Antidiuretic Hormone ◽  
Natriuretic Peptide ◽  
Plasma Concentrations ◽  
Dietary Sodium ◽  
Sodium Balance ◽  
Diurnal Changes ◽  
Renin Angiotensin ◽  
Atrial Natriuretic

1. Diurnal changes in plasma concentrations of atrial natriuretic peptide (ANP), renin, angiotensin II, aldosterone, Cortisol and antidiuretic hormone were investigated in seven normal volunteers studied under standardized conditions of dietary sodium, posture and physical activity. After completion of the diurnal study serial measurements of these variables were continued during, and on recovery from, a 2 day period of severe sodium depletion. 2. Clear diurnal variations in plasma concentrations of renin, angiotensin II, aldosterone, Cortisol and antidiuretic hormone were observed. 3. Plasma ANP concentrations also varied significantly over 24 h. Values peaked about mid-day and a distinct trough in peptide concentrations occurred in the early evening. However, variations in plasma ANP values were of relatively small amplitude and not clearly independent of modest parallel shifts in sodium balance. 4. Changes in plasma ANP concentrations both within the diurnal study period and during sodium deprivation were closely and positively correlated with concomitant changes in cumulative sodium balance. 5. No simple parallel or reciprocal relationships between plasma concentrations of ANP, on the one hand, and concurrent plasma concentrations of other hormones or in the rate of urinary sodium excretion, on the other, were observed during the 25 h of the diurnal study.

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