Why the study?
Does alpha-human ANP injection affect blood pressure, diuresis, and aldosterone levels differently in patients with low renin essential hypertension and primary aldosteronism compared to normal volunteers?
Does alpha-human ANP injection affect blood pressure, diuresis, and aldosterone levels differently in patients with low renin essential hypertension and primary aldosteronism compared to normal volunteers?
Alpha-human ANP retains its renal diuretic effects in low renin hypertension and primary aldosteronism, but its aldosterone-inhibiting properties are blunted compared to normal subjects.
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ANP's preserved diuretic action in low-renin hypertension supports further study; leaves open therapeutic relevance given blunted aldosterone effects.
Atrial natriuretic peptide (ANP), besides its diuretic and antihypertensive effects, exhibits an "in vitro" inhibitory action on aldosterone. In order to elucidate if these effects are present also "in vivo", we injected 100 micrograms of alpha-human ANP as a bolus in normal volunteers, low renin essential hypertensive subjects (LRH) and in patients with primary aldosteronism (PA). A transient hypotensive effect was seen in all patients, without significant variations of heart rate. The diuretic and saluretic effects of ANP were greater in hypertensive subjects, even in PA where endogenous ANP levels are known to be elevated. Plasma aldosterone values decreased significantly only in normal volunteers. In conclusion, in LRH and PA renal effects of ANP are not diminished, although its aldosterone-inhibiting properties are less evident than in normals.
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Mantero et al. (1987) studied this question.
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