Why the study?
Does nifedipine acutely increase plasma ANP in normotensive and hypertensive patients?
Does nifedipine acutely increase plasma ANP in normotensive and hypertensive patients?
Nifedipine acutely increases plasma ANP in normotensive subjects but has blunted effects in hypertensive patients, which may suppress aldosterone increases in response to elevated PRA.
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Blunted ANP response to nifedipine in hypertensives warrants caution in assuming uniform effects; leaves open mechanisms involving PRA and aldosterone.
The physiology of atrial naturiuretic peptide (ANP) secretion was studied in normotensive subjects and hypertensive patients both young and old. Basal plasma ANP concentration was least in young normotensives, intermediate in old normotensives and young hypertensives, and highest in old hypertensives. Nifedipine, a known stimulator of ANP secretion, acutely increased plasma ANP in young and old normotensive subjects but not in young hypertensive patients and half of the old hypertensive patients. Increase in serum ANP level in response to nifedipine did not augment its hypotensive effect. However, the increase of aldosterone in response to nifedipine-induced rise in plasma renin activity (PRA) seemed to be suppressed by elevated ANP.
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Shigematsu et al. (1992) studied this question.
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