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Plasma Levels of Atrial Natriuretic Peptide in Primary Aldosteronism and Essential Hypertension

Third Department ofInternal Medicine, Faculty of Medicine, University of Tokyo Hongo, Tokyo
Institute for Adult Diseases, Asahi Life Foundation Shinjuku, Tokyo, Japan

Address requets for reprints to: Tohru Yamaji, M.D., Third Department of Internal Medicine, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113, Japan.

Plasma levels ofatrial natriuretic peptide(ANP) were measured in 9 patients with primary aldosteronism and 41 patients with essential hypertension (class I or II by WHO classification) using a specific and sensitive RIA. The mean plasma ANP concentration in patients with primary aldosteronism (mean ± SEM,67.1 ± 10.8 pg/ml; n = 9) was significantly higher than that in healthy normotensive subjects (37.9 ± 1.4 pg/ml; n = 108)or patients with essential hypertension (38.5 ± 2.8 pg/ml; n = 41). During treatment with spironolactone, plasma levels of ANP declined in 6 of the 7 patients with primary aldosteronism, but no change occurred in the remaining patient who had cardiac enlargement of unknown etiology. The mean plasma ANPconcentration in patients with essential hypertension, on the other hand, wasnot significantly different from that in normal subjects. These results indicate that plasma ANP levels are elevated in patients with primary aldosteronism, probably due to volume expansion, whereas no abnormality in ANP secretion exists in patients with uncomplicated essential hypertension.

Received January 17, 1986.

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