Relation of Pulse Pressure to Neurohumoral Factors in Patients with Primary Hypertension

Abstract

Background Increased pulse pressure, which is responsible for mechanical stress on blood vessels, may have a significant contribution to specific organ involvement in hypertension. The aim of the study was to determine relations between pulse pressure and neurohumoral factors which play important role in pathophysiology of hypertension.
Material and methods The study was performed in 60 patients with primary hypertension aged 18–79 yr. (average 54 ± 16 yr). According to classification of Polish Society of Hypertension patients were divided in 3 group of mild, moderate and severe hypertension and on the basis of measurements of pulse pressure (PP) were divided on three group where PP < 55 mm Hg, 55–65 mm Hg and > 65. Levels of natriuretic peptides (ANP and BNP), endothelin-1, (ET-1), neuropeptide Y (NPY) and plasma renin activity (ARO) were measured using radioimmunoassay method. In all patients echocardiography, laboratory testing of sodium and potassium serum levels and their urinary excretion were performed.
Results In patients with severe hypertension and in the group with the highest PP significant increase of ANP level compared to group with lower PP and significant correlation between PP and level of ANP and NPY was found. Contrary to ANP, level of BNP was significantly diminished in patients with severe hypertension and high PP.
Conclusion Significantly increased level of ANP and NPY in patients with the highest pulse pressure and highly significant correlation between pulse pressure and level of ANP and NPY indicates the importance of pulsatile flow for secretion of these peptides in hypertensive patients.