Atrial natriuretic factor infusion in pre-hypertensive men revealed decreased basal plasma c-GMP and blunted c-GMP response (p<0.05 to <0.01), despite normal renal excretory responses.
RCT (n=14)
Single-blind
randomized sequence
Does ANF infusion alter plasma c-GMP and renal responses differently in normotensive sons of hypertensive parents compared to sons of normotensive parents?
Pre-hypertensive individuals exhibit a disturbance in the ANF-c-GMP regulatory pathway at the circulatory level, with lower basal plasma c-GMP and blunted c-GMP response to ANF, despite normal renal responses.
p-value: p=<0.001
The amount of, and response of the kidneys to, endogenous natriuretic factor(s) could be important in the pathogenesis of essential hypertension. Searching for possible disturbance(s) related to atrial natriuretic factor (ANF) and its second messenger, cyclic guanosine monophosphate (c-GMP), we assessed plasma immunoreactive (ir) ANF and c-GMP, effective renal plasma flow (ERPF), glomerular filtration rate (GFR), urinary c-GMP, absolute and fractional (FE) excretions of sodium (Na) and chloride (Cl) before and during infusions of low ANF doses or vehicle (V) in 7 normotensive sons of essential hypertensive parents (SEH) compared with 7 sons of normotensive parents (SN). Each subject was infused at 2-week intervals in a single-blind randomized sequence with 4 different solutions: V only or ANF 0.004, 0.008 and 0.016 microgram/kg/min, infused over 90 min. Plasma irANF was lower in SEH than in SN (p < 0.001) during vehicle infusion. Basal plasma c-GMP levels were, on all 4 different study days lower (p < 0.05 to < 0.01) in SEH in SN. Response of plasma c-GMP to infused ANF was also slightly decreased in SEH (p < 0.05 to < 0.01). BP, ERPF and GFR did not differ between SEH and SN and were unchanged during the 4 infusions. Urinary c-GMP excretion, FENa and FECl increased dose-dependently during ANF (p < 0.05 to < 0.0001) but not V infusions. These findings indicate that at the stage of pre-hypertension a disturbance in the ANF-c-GMP regulatory pathway may occur, which is expressed primarily at the circulatory rather than the renal excretory level.
Ferrari et al. (Mon,) conducted a rct in Pre-hypertension (n=14). Atrial natriuretic factor (ANF) vs. Vehicle was evaluated on Plasma immunoreactive ANF and c-GMP, effective renal plasma flow, glomerular filtration rate, and urinary excretions (p=<0.001). Atrial natriuretic factor infusion in pre-hypertensive men revealed decreased basal plasma c-GMP and blunted c-GMP response (p<0.05 to <0.01), despite normal renal excretory responses.