The Mechanisms of Hypertension.-Sodium and the Atrial Natriuretic Factor

Abstract

In this review, the authors give a brief summary of the history of hypertension research, especially during the period of 1948 to 1988, from the point of view that sodium regulation is involved in all aspects of hypertension and in its basic mechanisms. They present their views based on a 40-year study of the various mechanisms involved in hypertension. Evidence obtained by Larochelle and his group at the Clinical Research Institute of Montreal was provided on plasma concentration of C-terminal IR-ANF (Ser 99-Tyr 126), N-terminal ANF (Asn 1-Arg 98) and cyclic GMP in patients with essential hypertension which demonstrated conclusively that these levels are within the normal range in patients with various degrees of severity of essential hypertension. The only patients (one-third) in whom plasma IR-ANF was found to be increased, were those under antihypertensive medication with poor control of blood pressure and with severe hypertension. These results suggest the possibility of an atrial hyporesponsiveness to release ANF in essential hypertension.