The relation of plasma level of atrial and brain natriuretic peptides to left ventricular function in hypertensive patients

Abstract

Objective: To examine the plasma level of atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) in patients with hypertension and to evaluate the importance of plasma level of these hormones in predicting the left ventricular function in these patients.
Design: A case-series study.
Setting: Echocardiography Unit of Ibn-Sena teaching hospital and Medical college, Mosul. During the period from August 2004 to March 2005.
Participants: Sixty patients with essential hypertension, were divided into 3 groups depending on severity of the disease. Group I, included 17 patients, group II, included 24 patients and group III, included 19 patients. The study also included 30 apparently healthy volunteers as a control group.
Methods: Plasma ANP, BNP and left ventricular ejection fraction (LVEF%) were measured in hypertensive patients as well as in the control group. The ANOVA test was used to examine the difference in the mean of the studied parameters within patient groups themselves and between patient groups and control. Pearson correlation coefficient was used to study the correlation of the studied parameters within each group. All values are expressed as mean ±SD.
Results: The mean of plasma ANP was significantly higher in group III than that in control group (p<0.001) and group I (p<0.05). The mean of plasma BNP was significantly higher in group III than that in control group (p<0.0001), group I (p<0.0001) and group II (p<0.0001). Furthermore, the plasma BNP was significantly higher (p<0.01) in group II than that in control group. The mean of LVEF% was significantly lower in group III than that in control group (p<0.0001), group I (p<0.0001) and group II (p<0.001). There was a significant negative correlation between plasma BNP level and LVEF% in group III (r = - 0.62, p< 0.005).
Conclusion: The results of this study showed that plasma ANP and BNP levels are significantly increased in patients with severe hypertension. The results also indicate that BNP may be an excellent screening test for left ventricular dysfunction in hypertensive patients.