Cardiac Natriuretic Peptides, Hypertension and Cardiovascular Risk

Sarzani, Riccardo; Spannella, Francesco; Giulietti, Federico; Balietti, Paolo; Cocci, Guido; Bordicchia, Marica

doi:10.1007/s40292-017-0196-1

Cited by 63 publications

(53 citation statements)

References 113 publications

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“…The exact mechanism through which testosterone reduces cardiac NP levels remains poorly understood, although up-regulation of neprilysin activity by testosterone may be one possible explanation. 105,106 The role of female sex hormones in modulating plasma concentrations of cardiac NPs appears to be complicated: although oestrogen may increase cardiac NP levels by directly increasing cardiac NP gene expression and release, 107,108 or by increasing the NPR-A to NPR-C ratio, [109][110][111] there are also reports suggesting that oestrogen increases neprilysin activity. 112,113 In the clinical setting, evidence regarding the association of endogenous female sex hormones with higher cardiac NP levels is limited; some studies, however, indicate that exogenous female hormone therapy may contribute to higher cardiac NP levels.…”

Section: Unlikelymentioning

confidence: 99%

Sex‐related differences in contemporary biomarkers for heart failure: a review

Suthahar

Meems

et al. 2020

European J of Heart Fail

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The use of circulating biomarkers for heart failure (HF) is engrained in contemporary cardiovascular practice and provides objective information about various pathophysiological pathways associated with HF syndrome. However, biomarker profiles differ considerably among women and men. For instance, in the general population, markers of cardiac stretch (natriuretic peptides) and fibrosis (galectin‐3) are higher in women, whereas markers of cardiac injury (cardiac troponins) and inflammation (sST2) are higher in men. Such differences may reflect sex‐specific pathogenic processes associated with HF risk, but may also arise as a result of differences in sex hormone profiles and fat distribution. From a clinical perspective, sex‐related differences in biomarker levels may affect the objectivity of biomarkers in HF management because what is considered to be ‘normal’ in one sex may not be so in the other. The objectives of this review are, therefore: (i) to examine the sex‐specific dynamics of clinically relevant HF biomarkers in the general population, as well as in HF patients; (ii) to discuss the overlap between sex‐related and obesity‐related effects, and (iii) to identify knowledge gaps to stimulate research on sex‐related differences in HF.

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Section: Unlikelymentioning

confidence: 99%

Sex‐related differences in contemporary biomarkers for heart failure: a review

Suthahar

Meems

et al. 2020

European J of Heart Fail

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“…) . ANP and BNP (with lower affinity) bind selectively to NPR‐A, while CNP binds to NPR‐B and NPR‐C and leads to activation of intracellular pathways . By binding to NPR‐C, natriuretic peptides are cleared from the bloodstream by endocytosis and intracellular inactivation .…”

Section: The Natriuretic Peptide (Np) Systemmentioning

confidence: 99%

The Combination of Valsartan and Sacubitril in the Treatment of Hypertension and Heart Failure – an Update

Nielsen

Grimm

Wehland

et al. 2017

Basic Clin Pharma Tox

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A novel antihypertensive drug, LCZ696 (Entrestoâ), has recently been introduced, which combines the action of an antagonist of the renin-angiotensin-aldosterone system (RAAS), effectively decreasing the blood pressure, with an inhibition of neprilysin, which is responsible for metabolizing natriuretic peptides exerting antihypertensive and antifibrotic effects. In this MiniReview, we describe the pharmacokinetics and pharmacodynamics, efficacy and side effects of the combined angiotensin receptor antagonist and neprilysin inhibitor LCZ696. We summarize the effect of LCZ696 treatment of patients suffering from hypertension and heart failure (HF) and further highlight the role of this new drug as a treatment option in the future. In the earlier stages of the treatment of patients with heart failure, LCZ696 was superior in lowering the blood pressure compared to olmesartan, while the effect on blood pressure at long-term treatment was comparable for the two drugs. The numbers of adverse effects were comparable. LCZ696 was superior to enalapril in reducing mortality, hospitalizations and HF symptoms. Adverse effects were reduced with a slower up-titrating regimen of 6 weeks. The current results are promising and suggest that LCZ696 will be a new candidate for first-line treatment of HF. However, it needs to be explored whether LCZ696 is safe in pregnant women, what are the effects of long-term LCZ696 treatment on survival and whether the antifibrotic effects can be of major benefit in, for example HF with preserved ejection fraction.

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“…BNP may play a crucial role in maintaining cardiovascular hemodynamics with an impact on BP regulation. BNP may reduce BP through several mechanisms, such as increased renal perfusion and natriuresis, renin-angiotensin-aldosterone system inhibition, and arterial dilation [ 17 ]. The induction of the BNP gene results in the production and secretion of prohormone proBNP 1-108 .…”

Section: Discussionmentioning

confidence: 99%

Blood Pressure Profile and N-Terminal-proBNP Dynamics in Response to Intravenous Methylprednisolone Pulse Therapy of Severe Graves’ Orbitopathy

Miśkiewicz

Milczarek-Banach

Bednarczuk

et al. 2018

IJMS

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Hypercortisolemia is associated with increased risk of hypertension. Natural and synthetic glucocorticoids (GCs) have different effects on blood pressure (BP). The effect of synthetic GCs on BP depends on the dose, treatment duration, type of GCs, and route of administration. Intravenous methylprednisolone (IVMP) pulse therapy is the first line of treatment for severe Graves’ orbitopathy (GO). The aim of this study was to evaluate influence of IVMP pulses on BP and N-terminal pro-brain natriuretic peptide (NT-proBNP) dynamics. A total of 32 patients with GO were treated with one IVMP pulse every week for 12 weeks. We performed 48-h BP monitoring (24-h before and 24-h after IVMP) and measured NT-proBNP before, 24 h, and 48 h after the 1st, 6th, and 12th IVMP pulse. Mean BP did not change after any of the pulses. We did not observe an increase in maximal systolic BP or mean nocturnal BP, except after the last pulse. Additionally, the dipping phenomenon was less frequent after the last pulse. We found a significant increase in median NT-proBNP levels after all analyzed pulses. Our study suggests that IVMP may have an unfavorable cumulative effect on BP. Variation in NT-proBNP concentration indicates a compensatory effect of brain natriuretic peptide secretion.

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Cardiac Natriuretic Peptides, Hypertension and Cardiovascular Risk

Cited by 63 publications

References 113 publications

Sex‐related differences in contemporary biomarkers for heart failure: a review

Sex‐related differences in contemporary biomarkers for heart failure: a review

The Combination of Valsartan and Sacubitril in the Treatment of Hypertension and Heart Failure – an Update

Blood Pressure Profile and N-Terminal-proBNP Dynamics in Response to Intravenous Methylprednisolone Pulse Therapy of Severe Graves’ Orbitopathy

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