Atrial natriuretic factor response to acute volume expansion in borderline hypertension. Role of ACE-inhibition and changes in peripheral venous tone

Clin Exp Hypertens. 1993 Mar;15(2):339-54. doi: 10.3109/10641969309032938.

Abstract

Abnormalities in the response of atrial natriuretic factor (ANF) to volume expansion have been reported in hypertensive-prone animals and men as well as in hypertensive patients undergoing ACE-inhibition. To investigate some of the mechanisms affecting ANF release in borderline hypertensive patients (BHT) we have studied 16 subjects by assessing their neuro-humoral and hemodynamic response to a two-hour isotonic i.v. NaCl infusion carried out during short-term administration of either placebo or captopril. ACE-inhibition increased baseline venous distensibility (VV30:1.4 vs 1.6 ml/100 ml; p < .05) and reduced the prompt (45') ANF response to saline loading (10.3 +/- 13 vs 42.7 +/- 15%; p < .05)) without affecting the overall ANF release (120':92 +/- 25 vs 65.8 +/- 20%; NS)). A significant pressor increase in response to NaCl loading was observed exclusively after ACE-inhibition (SBP: 5.2 +/- 2 vs 2.4 +/- 1%; p < .05--DBP: 7.1 +/- 3 vs 2 +/- 3%; p < .025) and occurred along with a peripheral arterial and venous constriction and with an increase in plasma levels of an endogeneous Na+/K+ATPase inhibitor (8.8 +/- 4 vs -2 +/- 4%; p < .05). We conclude that the ANF response to saline infusion is delayed by ACE-inhibition in borderline hypertensives. The abnormalities observed in ANF response could follow the changes in peripheral venous distensibility and contribute to the pressor and neuro-humoral derangements described in borderline hypertensives during volume expansion.

Publication types

  • Clinical Trial
  • Controlled Clinical Trial

MeSH terms

  • Adolescent
  • Adult
  • Atrial Natriuretic Factor / blood
  • Atrial Natriuretic Factor / metabolism*
  • Blood Pressure / drug effects
  • Blood Pressure / physiology
  • Blood Volume / physiology*
  • Captopril / pharmacology
  • Humans
  • Hypertension / drug therapy
  • Hypertension / physiopathology*
  • Renin / blood
  • Sodium Chloride / administration & dosage
  • Vascular Resistance / drug effects
  • Vascular Resistance / physiology
  • Vasodilation / drug effects
  • Vasodilation / physiology

Substances

  • Sodium Chloride
  • Atrial Natriuretic Factor
  • Captopril
  • Renin