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Query: UMLS:C0085580 (essential hypertension)
 14,686 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In initial studies of human atrial natriuretic factor (ANF) administered to man, 100 microns intravenous bolus doses infused in normal volunteers and patients with essential hypertension resulted in clear increases in urinary excretion of sodium (four- to sixfold), urine volume, calcium, magnesium, and phosphorous. In addition, in both groups an acute but short-lived fall in blood pressure and rise in heart rate was observed. In these studies and other high dose constant infusion experiments, the response of the renin-angiotension-aldosterone system and plasma catecholamines was varied, either remaining unchanged or showing stimulation when high doses of ANF caused acute and substantial falls in blood pressure. In contrast, constant low-dose infusions of ANF in both normal and hypertensive man (0.75-2 pmol/kg/min) have consistently shown clear suppression of plasma concentrations of renin, angiotensin II, and aldosterone by at least 50% of baseline values. Such "physiological" doses of ANF are not associated with sympathetic nervous system activation even though subtle but significant falls in blood pressure (particularly systolic) may occur.
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PMID:Atrial natriuretic factor administered to humans: 1984-1988. 247 55

Atrial natriuretic peptide (ANP) infused intra-arterially into the forearm results in a dose-dependent vasodilator response of rapid onset. The maximal forearm vasodilator response to ANP amounts to about 60% of the maximal forearm vasodilator response to sodium nitroprusside and combined infusion of ANP and sodium nitroprusside has an additive vasodilator effect. ANP-induced vasodilation is greater than that of postjunctional alpha 1- or alpha 2-adrenoceptor blockade or of beta 2-adrenoceptor stimulation but is smaller than due to calcium entry blockade. ANP-induced vasodilation can easily be overcome by norepinephrine and to a lesser extent by angiotension II (Ang II). The similarity of the dose-response relationships for vasodilation and for natriuresis suggests that ANP may be equally effective on its renal and vascular targets. In patients with essential hypertension, intra-arterial infusion of ANP produced a greater vasodilator response than in normotensives and this was inversely related to plasma renin activity, suggesting greater vasodilator responsiveness to ANP in low-renin hypertension. ANP caused vasodilation in humans but this may become less apparent when ANP is infused into the systemic circulation because of cardiovascular sympathetic reflex mechanisms blunting ANP vasodilation. Although the role of ANP in circulatory disease states is unclear, it appears that it could serve a physiological function as an endogenous vasodilator (and natriuretic) principle for volume homeostasis in humans.
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PMID:The vasodilating effect of atrial natriuretic peptide in normotensive and hypertensive humans. 247 56

Low dose iv infusion (0.01 and 0.03 micrograms/kg per min, for 30 min each) of alpha-human atrial natriuretic factor (alpha-hANF) produced a significant increase (+300%) in urinary protein excretion in patients with essential hypertension but not in normotensive controls, when their renal function was normal. The major component of excreted proteins induced by alpha-hANF infusion was presumed to be albumin on the basis of molecular weight (69,000) analyzed by sodium dodecyl sulfate (SDS)-polyacrylamide gel electrophoresis. Urine output and sodium and potassium excretion rates were increased dose-dependently by alpha-hANF infusion in the hypertensive patients in a similar fashion to those in the controls. Glomerular filtration rate (GFR) remained unchanged in the controls but was slightly increased in the patients (+33%) during the infusion. These results suggest that besides its previously recognized physiological functions such as natriuresis and diuresis, ANF plays an important role in the regulation of renal handling of proteins in patients with essential hypertension.
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PMID:Atrial natriuretic factor (ANF) increases urinary protein excretion in patients with essential hypertension: a possible role of ANF for renal handling of protein. 252 2

We measured circulating levels of immunoreactive atrial natriuretic factor (ANF) in 10 patients with untreated, uncomplicated mild to moderate essential hypertension and in 15 normotensive controls. ANF concentrations were significantly higher in the hypertensive group than in the control group (38.4 +/- 6.9 pg/ml versus 18.3 +/- 1.8 pg/ml, p less than 0.02). A positive correlation between ANF levels and systolic, diastolic and mean blood pressure was noted in the total study population (p less than 0.008, r = 0.52; p less than 0.005, r = 0.55; p less than 0.02, r = 0.46, respectively). Thus, plasma ANF concentrations are elevated in essential hypertension and may result from increased intraarterial pressure.
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PMID:Atrial natriuretic factor in essential hypertension. 252 79

The role of atrial natriuretic factor (ANF) in the genesis of primary hypertension is not clear. However, a natriuretic and blood pressure lowering effect has been observed after infusion of ANF. Therefore, subjects at risk of future hypertension might be deficient in ANF or less responsive to it. To address this question we studied ANF, sodium excretion and blood pressure in 180 young normotensive people with different probabilities of developing hypertension later in life. The 180 subjects had either two, one or no hypertensive parents. Sixty-nine offspring had a high, 58 an intermediate and 53 a small probability of developing hypertension ('high', 'mixed' and 'low' groups). Mean plasma levels of ANF did not differ among the three groups of offspring. A negative association was found between ANF and diastolic blood pressure, being most pronounced in the low-risk group. The similar levels of plasma ANF in these groups suggest that ANF is not directly related to the development of high blood pressure.
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PMID:Similar plasma atrial natriuretic factor levels in children and young adults with a high and low probability of developing hypertension: the Dutch Hypertension and Offspring Study. 252 78

We performed an epidemiological study on the atrial natriuretic factor pattern in a young population. Subjects were recruited in the Ospedale Militare Principale of Rome among young men liable to conscription, whose hospitalization was due either to essential hypertension or to other pathologies (not influencing our study, such as headache etc.). The recruitment lead to the formation of three different groups: normotensives, normotensives with family history of hypertension (mother and/or father) and hypertensives. On the morning of the study (after 7 days of pharmacological wash-out, under a diet containing 120 mEq of Na+/die), blood samples were taken. Plasma atrial natriuretic factor, renin activity and aldosterone were assayed by RIA. Digoxin-like immunoreactive substance was assayed by a solid-phase radioimmunoassay, following the extraction of plasma. Serum creatinine, sodium, potassium and urinary sodium and potassium (24 h before the study) were assayed by standard methods. Urinary kallikrein was assayed by chromogenic substrate S-2266. So far, we have studied 60 subjects (26 hypertensives, 21 normotensives and 13 normotensives with family history) and we wish to discuss in this article the preliminary results concerning the atrial natriuretic factor and its relationship with renin activity, aldosterone and blood pressure. Our results show that the mean plasma levels of atrial natriuretic factor in the hypertensive group were higher, although not significantly, than those of the other two groups and that the normotensives with family history had slightly higher levels as compared to normotensives (Delta % = + 7.4).(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Atrial natriuretic factor: an epidemiological study. Preliminary results]. 252 19

Investigation of changes of the atrial natriuretic factor plasma concentration (ANF), plasma renin activity (PRA) and the plasma aldosterone concentration (PAC) and their correlation with the renal excretion of urine, sodium and potassium before and after infusion of 2 1 saline in the course of 2 hours in 6 controls and 7 patients with essential hypertension (EH) revealed the same rise of ANF in plasma of both groups (from 2.98 +/- 0.45 to 12.36 +/- 1.74 pmol/l in controls and from 3.80 +/- 0.72 to 15.78 +/- 2.06 pmol/l in EH), a comparable decline of PRA (from 0.91 +/- 0.419 to 0.256 +/- 0.127 nmol/l/hr in controls and from 1.711 +/- 0.324 to 0.714 +/- 0.185 nmol/l/hr in EH), and PAC (from 0.30 +/- 0.07 to 0.14 +/- 0.03 nmol/l in controls and from 0.53 +/- 0.13 to 0.24 +/- 0.06 nmol/l in EH). The comparable rise of plasma ANF concentration during infusion of saline was associated with a significantly higher renal excretion of urine and sodium in EH, as compared with controls. The authors conclude from these results that the ANF release into the blood stream after an acute volume overload in EH does not differ from controls. Thus the raised natriuresis in EH after a volume overload cannot be explained solely by the rise of ANF. Its renal action depends obviously on the interaction with many other haemodynamic and renal mechanisms, and as regards humoral factors, in particular on the interaction with the renin-angiotensin-aldosterone system. The inhibitory action of elevated ANF concentrations might participate in the suppression of PRA and PAC after a volume overload.
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PMID:[Relation between atrial natriuretic factor and the renin-angiotensin-aldosterone system in the renal reaction to acute volume loading in patients with essential hypertension]. 252 71

Plasma concentrations of atrial natriuretic factor and some vasoactive substances were determined in 8 patients with aldosterone-producing adenoma, 10 with idiopathic adrenal hyperplasia, 10 normotensive subjects and 12 patients with essential hypertension. Plasma atrial natriuretic factor concentration in patients with aldosterone-producing adenoma was the highest among the examined groups. Adrenal surgery reduced plasma concentrations of atrial natriuretic factor and aldosterone concomitant with the elevation in urinary sodium excretion, plasma renin activity and urinary sodium-to-potassium ratio. Withdrawal of trilostane (3 beta-hydroxysteroid dehydrogenase inhibitor) in patients with idiopathic adrenal hyperplasia increased plasma concentrations of atrial natriuretic factor and aldosterone, and decreased the urinary sodium-to-potassium ratio, plasma renin activity and urinary sodium excretion. However, reduced urinary sodium excretion following trilostane treatment returned to the control level successively despite the high levels of plasma atrial natriuretic factor and aldosterone. Acute infusion of saline remarkably increased plasma atrial natriuretic factor concentration in patients with idiopathic adrenal hyperplasia and aldosterone-producing adenoma. These results suggest that a high level of atrial natriuretic factor is a characteristic feature in patients with aldosterone-producing adenoma caused chiefly by the expansion of extracellular fluid volume, and circulating atrial natriuretic factor may contribute to regulation of the sodium escape phenomenon in patients with aldosterone-producing adenoma or idiopathic adrenal hyperplasia.
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PMID:The effect of adrenal surgery on plasma atrial natriuretic factor and sodium escape phenomenon in patients with primary aldosteronism. 252 99

The author reviews contemporary views on the pathogenetic participation of selected humoral factors (of the renin-angiotensin-aldosterone system, natriuretic hormone and atrial natriuretic factor) in the development of arterial hypertension in humans. Hypertension may be due to absolute or relative excess of factors with a pressor and antinatriuretic action or to deficiency of depressor and natriuretic substances. In essential hypertension and the majority of other types of hypertension the position is more complicated. Humoral substances are there involved in a complex way in dynamic interaction with other genetic, nervous, cardiovascular and other mechanisms. Investigation of humoral substances has helped to elucidate the causes of endocrine-hypertension, to expand our knowledge on the multifactorial genesis of essential hypertension, to differentiate its subtypes, and it led also practical therapeutic outcome such as the use of inhibitors of the angiotensin I converting enzyme or spirolactone.
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PMID:[Humoral mechanisms in the pathogenesis of arterial hypertension with emphasis on the renin-angiotensin-aldosterone system and natriuretic substances]. 252 99

Atrial natriuretic factor was infused in a low dose (0.2 microgram/min) during 5 days in six patients with essential hypertension. Atrial natriuretic factor infusion caused plasma levels of atrial natriuretic factor to increase from 49 +/- 10 to 106 +/- 19 pg/ml. Within 4 hours after the start of the atrial natriuretic factor infusion, urinary sodium excretion increased in all subjects. Sodium balance was regained after 24 hours with a net loss of 72.3 +/- 14.6 mmol. However, systolic as well as diastolic blood pressure started to decrease gradually in all subjects only after 12 hours of atrial natriuretic factor infusion, reaching a stable level after 36 hours with a decrease of 11.5 +/- 1.5% and 10.3 +/- 0.8%, respectively. Heart rate increased in parallel by 12.6 +/- 3.1%. Hematocrit rose 7.1 +/- 2.3%. After cessation of atrial natriuretic factor infusion, plasma atrial natriuretic factor levels, sodium balance, and hematocrit returned to baseline within 24 hours, whereas blood pressure slowly returned toward baseline values over 3 days. These data show that chronic atrial natriuretic factor infusion in patients with essential hypertension causes a negative sodium balance and a rise in hematocrit, followed by a smooth decrease in blood pressure with a rise in heart rate until a new equilibrium is reached after approximately 2 days. Thus, atrial natriuretic factor in low doses appears intimately involved in the regulation of sodium balance and blood pressure in humans. Moreover, these data suggest that atrial natriuretic factor-like substances will eventually become useful antihypertensive drugs.
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PMID:Antihypertensive effect of a 5-day infusion of atrial natriuretic factor in humans. 252 24


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