Plasma adrenomedullin and atrial natriuretic peptide concentrations in patients with essential hypertension

ABSTRACT

The aim of this study was to determine the changes of plasma concentrations of adrenomedullin [AM] and atrial natriuretic peptide [ANP] in patients with essential hypertension and the relation between plasma AM and some clinical, renal and cardiac function variables. Plasma AM and ANP were measured in 60 patients with essential hypertension and 30 normotensive control subjects. Hypertensive patients were classified according to the joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure [JNC-VI] into 20 cases stage 1 [mild hypertension], 20 cases stage 2 [moderate] and 20 cases stage 3 [severe hypertension]. The concentrations of plasma AM and ANP were significantly increased in hypertensive patients compared to normotensive control subjects, although plasma AM values in normotensive subjects and stage 1 hypertensive patients were not statistically different. Plasma AM concentrations were positively correlated with the ANP, mean arterial blood pressure and serum creatinine levels and inversely correlated with glomerular filtration rate [creatinine clearance], left ventricular ejection fraction [LVEF] and left ventricular fractional shortening [LVFS]. It was concluded that plasma AM and ANP concentrations increased in proportion to the severity of hypertension in hypertensive patients and plasma AM levels correlated positively with ANP, serum creatinine, mean arterial blood pressure and inversely with creatinine clearance [GFR], LVEF and LVFS. The present findings suggested that these vasodilator peptides are involved in the pathogenesis of hypertension acting against further elevation of blood pressure in patients with essential hypertension