Key result
Atrial natriuretic peptide infusion elicited a similar increase in cGMP relative to ANP levels in both young and elderly subjects, though lower clearance in the elderly led to greater absolute levels.
Why the study?
Does the sensitivity to atrial natriuretic peptide (ANP), as measured by cGMP response, differ between healthy young and elderly subjects?
RCT (n=16)
Double-blind
random-order
Does the sensitivity to atrial natriuretic peptide (ANP), as measured by cGMP response, differ between healthy young and elderly subjects?
Elderly subjects have similar target organ sensitivity to ANP as young subjects, but experience greater elevations in ANP and cGMP from a similar dose due to lower clearance.
Answers are grounded in this paper and cite their sources.
Indicates preserved ANP sensitivity in elderly; extends pharmacokinetic data to inform age-adjusted dosing in future trials.
OBJECTIVE: To compare the sensitivity to atrial natriuretic peptide (ANP) in young and elderly subjects. DESIGN: Double-blind, random-order, placebo-controlled study using two different rates of ANP infusion. SUBJECTS: Eight healthy young (23 +/- 3 years, mean +/- SD) and eight healthy elderly (76 +/- 4 years) subjects recruited from the general population. MEASUREMENT: Plasma cyclic guanosine monophosphate (cGMP, the second messenger of ANP) levels reflecting the sensitivity of biologically active ANP receptors. RESULTS: Baseline ANP levels were higher and rose to a greater extent in the elderly both during low- (0.25 microgram/min) and high-dose (2.0 micrograms/min) infusion of ANP. Plasma levels of cGMP rose in proportion to the increase in ANP. When the rise in cGMP levels was related to the increase in ANP levels (expressed as nmol/L per 100 pg/mL ANP increase), no difference was found between young and elderly subjects. CONCLUSION: The ability of elderly subjects to increase cGMP in response to exogenous ANP is similar to that of young subjects. This may reflect a similar sensitivity of the target organs towards ANP. However, because of lower clearance in the elderly, a similar dose of ANP results in a greater elevation of ANP and cGMP levels and hence induces a greater effect.
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Tan et al. (1993) conducted an RCT in Healthy (n=16). Atrial natriuretic peptide (ANP) vs. Placebo was evaluated on Plasma cyclic guanosine monophosphate (cGMP) levels. Atrial natriuretic peptide infusion elicited a similar increase in cGMP relative to ANP levels in both young and elderly subjects, though lower clearance in the elderly led to greater absolute levels.
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