Natriuretic Factors in Arterial Hypertension

Abstract

the possible roles of natriuretic factors in arterial hypertension are addressed in this chapter. We suspect that natriuretic factors are most important in the low-renin forms of arterial hypertension, i.e., those forms with 1) low plasma renin activity, 2) relative insensitivity to angiotensin antagonists and converting enzyme inhibitors, 3) relative sensitivity to dietary salt restriction and natriuretic-diuretic medication, and 4) absolute or relative volume expansion. Typical examples of these forms of hypertension are, in humans, primary aldosteronism, renal parenchymal disease, and low-renin essential hypertension in black male patients; examples in animals are reduced renal mass-saline hypertension; one-kidney, one clip hypertension; and one-kidney, deoxycorticosterone acetate (DOCA), saline hypertension. In this chapter we present our reasons for suspecting important roles for natriuretic factors in low-renin hypertension. Only two natriuretic factors are considered: one (de Wardener) that operates by inhibiting the sodium pump and one of atrial origin (de Bold) that does not.