Human Hypertension Is Characterized by a Lack of Activation of the Antihypertensive Cardiac Hormones ANP and BNP

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY

卷:60

Article

Macheret, Fima^1,2  Heublein, Denise²  Costello-Boerrigter, Lisa C.²  Boerrigter, Guido²  McKie, Paul²  Bellavia, Diego²  Mangiafico, Sarah^2,3  Ikeda, Yasuhiro⁴  Bailey, Kent⁵  Scott, Christopher G.⁴  Sandberg, Sharon²  Chen, Horng H.²  Malatino, Lorenzo⁶  Redfield, Margaret M.⁵  Rodeheffer, Richard⁵  Burnett, John, Jr.²  Cataliotti, Alessandro² 

[1] New York Presbyterian Hosp, Weill Cornell Med College, Dept Med, New York, NY 10065 USA

[2] Mayo Clin & Mayo Fdn, Cardiorenal Res Lab, Rochester, MN 55905 USA

[3] Univ Catania, Ferrarotto Hosp, Div Cardiol, Catania, Italy

[4] Mayo Clin & Mayo Fdn, Dept Mol Med, Rochester, MN 55905 USA

[5] Mayo Clin & Mayo Fdn, Dept Biostat, Rochester, MN 55905 USA

[6] Univ Catania, Dept Internal Med, Catania, Italy

关键词: ANP;    BNP;    hypertension;    natriuretic peptide;    NT-proBNP;    proBNP;   

DOI  :  10.1016/j.jacc.2012.05.049

来源: Elsevier

【 摘 要 】

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, BNP1-32 and N-terminal proBNP(1-76) (NT-proBNP(1-76)) were significantly decreased in pre-hypertension (p < 0.05), with BNP1-32 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 BNP1-32 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. (J Am Coll Cardiol 2012;60:1558-65) (c) 2012 by the American College of Cardiology Foundation

【 授权许可】

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