Anxiety disorders are associated with increased plasma adrenomedullin level and left ventricular hypertrophy in patients with hypertension.

OBJECTIVE: To investigate the association between anxiety disorders and left ventricular hypertrophy in patients with essential hypertension. METHODS: Left ventricular structure and function were assessed with echocardiography in 56 patients with essential hypertension and anxiety disorder (study group) and in 56 patients with hypertension only (control group). Serum adrenomedullin levels were also measured in these patients. RESULTS: There was no statistically significant difference in the left ventricular ejection fraction between the study and the control group (54.21 ± 88.81% versus 56.01 ± 7.85%, p>0.05). The left ventricular mass index (LVMI) in study group was higher than in control group (137.05 ± 9.42 versus 123.57 ± 7.01 g/m(2), p=0.001). The plasma levels of adrenomedullin in study group was higher than in control group (25.97 ± 5.48 versus 18.32 ± 6.97 ng/L, p=0.001). Levels of plasma adrenomedullin were positively correlated with LVMI in the study (r=0.734, p<0.05) and control group (r=0.592, p<0.05). CONCLUSION: Anxiety disorders are associated with elevated plasma adrenomedullin levels and increased left ventricular hypertrophy in patients with essential hypertension. The clinical significance of these changes requires further investigation.

Recombinant B-type natriuretic peptide nesiritide attenuates vascular remodelling by reducing plasma aldosterone in rabbits.

BACKGROUND: This study was designed to investigate the effect of nesiritide, a recombinant B-type natriuretic peptide (BNP), on plasma aldosterone and vascular remodelling following balloon-induced endothelial injuries to the iliac arteries. METHODS: Twenty-four male New Zealand rabbits were divided into nesiritide (0.1mg/kg/day, sc, for 4 weeks, n=12) and saline-treated control group (n=12). A balloon catheter was inserted to the right iliac artery to induce endothelia injuries. Plasma aldosterone was measured before and 28 days after the treatment by radioimmunoassay. RESULTS: The area under internal elastic membrane (657.1±129.6 vs 486.7±124.0µm(2), P=0.02) and the area under external elastic membrane (1506.2±188.3.9 vs 1185.0±202.9µm(2), P=0.02) in the nesiritide group were greater than in the control group. The stenosis ratio in the nesiritide group was lower than in the control group (20.1±6.2% vs 39.6±9.5%, P=0.01). The plasma levels of aldosterone (2.03±0.31 vs 3.00±0.29ng/L, P<0.01) in the nesiritide group was lower than in the control group. Pearson's correlation analysis showed a positive correlation between the levels of plasma aldosterone and the stenosis ratio of the injured right iliac arteries (r=0.622, P=0.002). CONCLUSION: Nesiritide treatment reduced stenosis ratio of the rabbit iliac artery following balloon-induced endothelial injuries, and the reduced stenosis ratio was associated with a reduction in the plasma aldosterone concentrations.