Atrial Natriuretic Peptide and Antihypertensive Action Due to β-Blockade in Essential Hypertensive Patients

Abstract

The effects of β-blocker treatment on hemodynamics were studied in relation to plasma atrial natriuretic peptide (ANP) levels in 17 outpatients with essential hypertension. Administration of propranolol for twelve weeks to untreated subjects resulted in a signif icant (P < 0.001) rise in plasma ANP levels (from 37.9 ±21.2 to 66.7 ±46.2 pg/mL, mean ±SD). Systolic and diastolic blood pressures were significantly decreased (P < 0.05 and P < 0.01, respectively). Heart rate was also significantly decreased (P < 0.001). On the other hand, a significant reduction of cardiac index was detected (from 4.12 ±1.34 to 2.96 ±0.75 L/min/m2, P < 0.01) with chronic administration of propranolol, suggesting a reflection of decreased cardiac function. A significant negative correlation was observed between %changes in systolic blood pressure and %changes in plasma ANP (r=-0.594, P < 0.05). These results suggest that the increased plasma ANP levels may contribute to the antihypertensive effect with propranolol.

Get full access to this article

View all access options for this article.

References

The Norwegian Multicenter Study Group: Timololinduced reduction in mortality and reinfarction in patients surviving acute myocardial infarction. N Engl J Med 304:801-807, 1981.

Hjalmarson A. , Herlitz J. , Holmberg S. , et al: The Göteborg metoprolol trial: Effects on mortality and morbidity in acute myocardial infarction . Circulation 67 (suppl I):I-26-I-32, 1983.

Nakaoka H. , Kitahara Y. , Amano M. , et al: Effect of β-adrenergic receptor blockade on atrial natriuretic peptide in essential hypertension. Hypertension 10:221-225, 1987.

Wing Lmh , Chalmers JP , West MJ , et al: Enalapril and atenolol in essential hypertension: Attenuation of hypotensive effects in combination. Clin Exp Hypertens, Part A, Theory Pract 10/1:119-133, 1988.

Hollenbeck M. , Plum J. , Heering P. , et al: Influence of betaxolol on renal function and atrial natriuretic peptide in essential hypertension . J Hypertens 9:819-824,1991.

Katori R. , Hayashi T. , Kanamasa K. , et al: Measurement of cardiac output by dye-dilution method with automatic calibration of dye concentration. Tohoku J Exp Med 122:51-58, 1977.

Katori R. , Ishikawa K. , Kohashi N. , et al: Changes in cardiac output by antihypertensive drug treatment in essential hypertension. Med J Kinki Univ 7 (suppl):83-93, 1982.

Cruickshank JM , Prichard Bnc : Beta-blockers in clinical practice . London: Churchill Livingston , 1987 , pp 284-297.

Cusson JR , Thibault G. , Cantin M. , et al: Prolonged low dose infusion of atrial natriuretic factor in essential hypertension. Clin Exp Hypertens, Part A, Theory Pract 12/1:111-135, 1990.

10.

Goetz KL : Physiology and pathology of atrial peptides. Am J Physiol 254:E1-E15, 1988.

11.

Agnoletti G. , Rodella A. , Ferrari R. , et al: Release of atrial natriuretic peptide-like immunoreactive material during stretching of the rat atrium in vitro. J Mol Cell Cardiol 19:217-220, 1987.

12.

Sonotani N. , Kubo S. , Nishioka A. , et al: Electrocardiographic and echocardiographic changes after one to two-years' treatment of hypertension . Jpn Heart J 22:325-333, 1981.

13.

Waagstein F. , Blomstrom-Lundquist C. , Andersson B. , et al: Long-term effects of metoprolol in severe heart failure due to ischemic cardiomyopathy, primary valve disease and diabetes. Circ 76 (suppl IV):358, 1987.

14.

Ruskoaho H. , Toth M. , Lang RE : Atrial natriuretic peptide secretion: Synergistic effect of phorbol ester and A 23187. Biochem Biophys Res Commun 133:581-588, 1985.

15.

Eichberg J. , Shein HM , Schwartz M. , et al: Stimulation of 32Pi incorporation into phosphatidyl inositol and phosphatidylglycerol by catecholamines and β-adrenergic receptor blocking agents in rat pineal organ cultures. J Biol Chem 248:3615-3622, 1973.