Human hypertension is characterized by a lack of activation of the antihypertensive cardiac hormones ANP and BNP
- PMID: 23058313
- PMCID: PMC4041520
- DOI: 10.1016/j.jacc.2012.05.049
Human hypertension is characterized by a lack of activation of the antihypertensive cardiac hormones ANP and BNP
Abstract
Objectives: This study sought to investigate plasma levels of circulating cardiac natriuretic peptides, atrial natriuretic peptide (ANP) and B-type or brain natriuretic peptide (BNP), in the general community, focusing on their relative differences in worsening human hypertension.
Background: Although ANP and BNP are well-characterized regulators of blood pressure in humans, little is known at the population level about their relationship with hypertension. The authors hypothesized that hypertension is associated with a lack of activation of these hormones or their molecular precursors.
Methods: The study cohort (N = 2,082, age >45 years) was derived from a random sample from Rochester, Minnesota, and each subject had a medical history, clinical examination, and assessment of different plasma forms of ANP and BNP. Patients were stratified by blood pressure. Multivariable linear regression was used to assess differences in natriuretic peptide levels in worsening hypertension.
Results: Compared to normotensive, BNP(1-32) and N-terminal proBNP(1-76) (NT-proBNP(1-76)) were significantly decreased in pre-hypertension (p < 0.05), with BNP(1-32) significantly decreased in stage 1 as well (p < 0.05). Although proBNP(1-108) remained unchanged, the processed form was significantly increased only in stage 2 hypertension (p < 0.05). ANP(1-28) remained unchanged, while NT-ANP(1-98) was reduced in pre-hypertension (p < 0.05).
Conclusions: The authors demonstrated the existence of an impaired production and/or release of proBNP(1-108) along with a concomitant reduction of BNP(1-32) and NT-proBNP(1-76) in the early stages of hypertension, with a significant elevation only in stage 2 hypertension. Importantly, they simultaneously demonstrated a lack of compensatory ANP elevation in advanced hypertension.
Copyright © 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
Conflict of interest statement
All other authors have reported that they have no relationships relavant to the contents of this paper to disclose.
Figures
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Comment in
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Lack of activation of the antihypertensive cardiac hormones ANP and BNP in human hypertension.J Am Coll Cardiol. 2013 Feb 26;61(8):900-1. doi: 10.1016/j.jacc.2012.10.043. Epub 2013 Jan 2. J Am Coll Cardiol. 2013. PMID: 23290544 No abstract available.
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