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(Hypertension. 1996;27:906-913.)
© 1996 American Heart Association, Inc.

Articles

Differing Metabolism and Bioactivity of Atrial and Brain Natriuretic Peptides in Essential Hypertension

Grant B. Pidgeon; A. Mark Richards; M. Gary Nicholls; Eric A. Espiner; Tim G. Yandle; Chris Frampton

From the Department of Medicine, Christchurch (New Zealand) School of Medicine, Christchurch Hospital.

Correspondence to Dr A. Mark Richards, Department of Medicine, Christchurch School of Medicine, Christchurch Hospital, PO Box 4345, Christchurch, New Zealand.

Abstract Plasma concentrations of both atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) are elevated in severe hypertension, acute myocardial infarction, and heart failure. In the current study of individuals with essential hypertension, we have documented the hemodynamic, hormonal, and endocrine effects of infusions of these two peptides given alone or in combination in equimolar doses calculated to induce increments in plasma peptides to concentrations (30 to 60 pmol/L) observed in these disease states. The metabolic clearance rate of ANP (4.56±0.62 L/min) was greater than that for BNP (3.4±0.23 L/min, P<.001). Infusions of each cardiac hormone impaired the clearance of coinfused peptide. All peptide infusions enhanced natriuresis (17% to 70% above preinfusion levels versus placebo, 6%; P<.001), lowered blood pressure (10 to 18 mm Hg fall in mean arterial pressure below placebo levels; P<.001), increased hematocrit, suppressed the renin-angiotensin-aldosterone system, and enhanced plasma norepinephrine concentrations. The natriuretic and blood pressure–lowering effects of BNP were twofold to threefold those of ANP. In contrast, ANP-induced increments in plasma and urinary second messenger (cGMP) levels were greater than those for BNP. Both peptides suppressed the renin-angiotensin-aldosterone system (approximately one-third fall in renin activity and plasma aldosterone) and enhanced plasma norepinephrine concentrations (+30%) to a similar degree. Increments in plasma ANP and BNP that occur simultaneously in cardiovascular disease states appear capable of causing hemodynamic, endocrine, and renal effects that would tend to ameliorate conditions such as hypertension or heart failure.

Key Words: natriuretic peptides • renin-angiotensin system • hypertension, essential • catecholamines • cyclic GMP • natriuresis

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