Patients with untreated essential hypertension had significantly higher plasma atrial natriuretic factor (ANF) levels (92.9 ± 12.9 pg/ml, mean ± SE) than those of age-matched controls (37.8 ± 6.0 pg/ml; p < 0.01). Plasma ANF levels in essential hypertensive patients showed a significant positive correlation with mean arterial pressure (MAP; r=0.46, p < 0.05) and an inverse correlation with plasma renin activity (PRA; r=-0.43, p < 0.05). Plasma ANF levels after medication showed significant correlation with the decrease hi MAP (r=0.565, p < 0.05). Patients with primary aldosteronism had significantly higher plasma ANF levels (122.4 ± 30.2 pg/ml, n=8) than those of controls (p < 0.05). The levels returned to normal after extirpation of adrenal tumors. The response of plasma ANF levels in patients with primary aldosteronism to volume expansion with infusion of 2 L of physiological saline in 2 hours was greater than hi controls. Such exaggerated response disappeared after surgical treatment. Infusion of angiotensin II (Ang II; 20 ng/kg/min) or norepinephrine (200 ng/kg/min) for 30 minutes to normal volunteers (n=5) resulted hi a rise hi MAP (24.9 ± 3.3 and 15.8 ± 4.4 mm Hg, respectively) and a twofold increase in plasma ANF level. Infusion of the Ang II antagonist [Sarl, Der, Ang II (600 ng/kg/min) for 30 minutes, resulted hi a rise hi MAP (18.8 ± 2.1 mm Hg) and more than a twofold increase ui plasma ANF level in patients with essential hypertension (n=6). The increase in the plasma ANF level by the agonistic pressor action of the Ang II antagonist significantly correlated with the increase in MAP (r=0.760, p <; 0.05). These results suggest that the plasma ANF level is one of the important clinical parameters for evaluating the hemodynamic state hi essential hypertension, primary aldosteronism, and other adrenal disorders.
ASJC Scopus subject areas
- Internal Medicine