Circadian Variation and Age Dependence of Human Atrial Natriuretic Peptide Levels in Hospitalized Patients

Circadian variation of plasma levels of human atrial natriuretic peptide (hANP) was studied in 8 patients less than or equal to 65 a of age (mean +/- SD = 43.8 +/- 13 a; 5 females, 3 males) and in 15 patients greater than 65 years of age (mean +/- SD = 81.4 +/- 5.7 a; 9 females, 6 males). Intraindividual variation was up to 40% relative to the day's mean level in both groups. A significant elevation of hormone levels in the evening was observed in patients greater than 65 years of age (P less than 0.002), no circadian rhythm could be detected in patients less than or equal to 65 years of age. All patients except the two eldest had average plasma levels of hANP within our normal range of 3-75 ng/l (N = 106; mean +/- SD = 29.9 +/- 15.3), found in healthy persons up to 65 years of age. We propose, that in the elderly hANP levels rise during the day by edema because of latent renal and/or cardial insufficiency. At rest, in the evening and during the night edema is eliminated by the well known nycturia, which might well be facilitated or at least partially caused by elevated levels of hANP.