DIFFERENT SECRETION PATTERNS OF ADRENOMEDULLIN, BRAIN NATRIURETIC PEPTIDE, AND ATRIAL-NATRIURETIC-PEPTIDE DURING EXERCISE IN HYPERTENSIVE AND NORMOTENSIVE SUBJECTS

The purpose of this study was to investigate the effect of exercise on plasma concentrations of adrenomedullin, brain natriuretic peptide (B NP), and atrial natriuretic peptide (ANP) in patients with essential h ypertension (n=15) and in normotensive controls (n=10). Exercise consi sted of two fixed workloads, 40 and 80 watts of work load using a supi ne bicycle ergometer. Plasma levels of all three peptides at rest were significantly higher in hypertensives than in controls. Plasma concen trations of ANP increased with exercise in both groups and had greater increments in hypertensive patients than in normotensives. Plasma con centrations of BNP increased only in patients with hypertension and th e levels of increase correlated with basal plasma BNP levels (r=0.94, p<0.001) and with left ventricular mass (r=0.62, p<0.01) determined by echocardiography. In contrast, plasma adrenomedullin did not change w ith exercise in either group. These results suggest that secretion pat terns of these peptides are regulated by different mechanisms and that the amount and kind of peptides mobilized by exercise may depend on t he underlying diseases or pathophysiologic condition.