CHANGES IN THE E A RATIO INDUCED BY HANDGRIP-EXERCISE ARE RELATED TO CHANGES IN THE PLASMA ATRIAL-NATRIURETIC-PEPTIDE LEVEL, BUT NOT TO CHANGES IN BRAIN NATRIURETIC PEPTIDE IN MILD ESSENTIAL-HYPERTENSION/

We investigated the relationship between changes in atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) and changes in card iac function during mild exercise in patients with mild hypertension. The handgrip test (HGT) was performed by 21 untreated, mildly hyperten sive patients, mean age 45+/-5 years. M-mode and pulse Doppler echocar diograms were recorded before and during HGT. In 7 patients (Group A), diastolic function, which was determined by the peak early velocity a nd peak atrial velocity (E/A) ratio using Doppler echocardiography was attenuated during HGT (1.19+/-0.21 to 1.04+/-0.16, p<0.05). There was no change in diastolic function in the remaining 14 patients (Group B ) (1.04+/-0.19 to 1.03+/-0.18, NS). Neither left ventricular mass inde x, left atrial diameter, cardiac index, ejection fraction, plasma reni n activity, plasma norepinephrine, blood pressure, nor heart rate were different between the two groups. While ANP was increased in Group A during HGT (from 41.0+/-18.2 to 54.0+/-24.1 pg/ml, p<0.05) it was unch anged in Group B (36.8+/-16.3 to 33.5+/-11.9 pg/ml). BNP did not chang e in either Group (Group A: 2.9+/-3.1 to 3.0+/-3.4 pg/ml, Group B: 2.6 +/-1.6 to 3.6+/-4.8 pg/ml). The percent change in ANP during HGT did n ot correlate with the percent change in BNP. Thus, the impairment of c ardiac functional reserve appeared to influence ANP excretion in patie nts with mild hypertension.