Hemodynamic and hormonal effects of atrial natriuretic factor in patients with essential hypertension

M. Volpe, A. F. Mele, C. Indolfi, N. De Luca, G. Lembo, A. Focaccio, M. Condorelli, B. Trimarco

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Hemodynamic and hormonal effects of two graded infusions of alpha-human-(1-28)-atrial natriuretic factor (0.5 μg/kg prime followed by 0.05 μg/kg per min for 20 minutes and by 0.1 μg/kg per min for 20 minutes) were evaluated in 13 patients with mild to moderate essential hypertension. The lower dose of atrial natriuretic factor did not change significantly any of the considered variables, although it tended to reduce aortic mean blood pressure (from 132.6 ± 5.3 to 125.5 ± 4.6 mm Hg), cardiac index (from 3.67 ± 0.2 to 3.54 ± 0.18 liters/min per m2) and forearm vascular resistance (from 178.6 ± 15 to 148.3 ± 10 mm Hg/ml per s). The higher dose of atrial natriuretic factor significantly reduced mean aortic pressure (118.6 ± 5 mm Hg), cardiac index (3.29 ± 0.16 liters/min per m2) and stroke volume index (from 45.9 ± 2.6 to 38.9 ± 3 ml/m2) and slightly decreased pulmonary wedge pressure, whereas both total peripheral resistance and forearm vascular resistance were not modified. With this latter dose a reduction in aortic pressure was observed in all patients at the steady state, and this was associated with a fall in stroke volume index in 10 of the 13 patients and with a reduction in total peripheral resistance in only 6 patients. Heart rate and right atrial and pulmonary pressures did not change during infusion of atrial natriuretic factor. Plasma renin activity was only slightly reduced by atrial natriuretic factor, whereas plasma norepinephrine rose significantly (from 233 ± 34 to 330 ± 58 pg/ml). Although heterogeneity in the hemodynamic responses to atrial natriuretic factor was noted, the results suggest that this peptide lowers aortic pressure in essential hypertension primarily through a reduction in stroke volume.

Original languageEnglish
Pages (from-to)787-793
Number of pages7
JournalJournal of the American College of Cardiology
Issue number4
Publication statusPublished - 1987

ASJC Scopus subject areas

  • Nursing(all)


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