Obese Hypertensive Men Have Lower Circulating Proatrial Natriuretic Peptide Concentrations Despite Greater Left Atrial Size
Abstract
BACKGROUND: Obese persons have lower circulating natriuretic peptide (NP) concentrations. It has been proposed that this natriuretic handicap plays a role in obesity-related hypertension. In contrast, hypertensive patients with left atrial enlargement have higher circulating NP concentrations. On this background, we investigated whether obese hypertensive men could have lower circulating NP concentrations despite evidence of pressure-induced greater left atrial size. METHODS: We examined 98 obese men (body mass index [BMI] ≥ 30.0 kg/m2) and 27 lean normotensive men (BMI 20.0–24.9 kg/m2). All men were healthy, medication free, with normal left ventricular ejection fraction. We measured blood pressure using 24-hour ambulatory blood pressure (ABP) recordings. Hypertension was defined as 24-hour ABP ≥ 130/80 mm Hg, and normotension was defined as 24-hour ABP < 130/80 mm Hg. We determined left atrial size using echocardiography, and we measured fasting serum concentrations of midregional proatrial NP (MR-proANP). RESULTS: Of the 98 obese men, 62 had hypertension and 36 were normotensive. The obese hypertensive men had greater left atrial size (mean ± SD: 28.7 ± 6.0 ml/m2) compared with the lean normotensive men (23.5 ± 4.5 ml/m2) and the obese normotensive men (22.7 ± 5.1 ml/m2), P < 0.01. Nevertheless, despite evidence of pressure-induced greater left atrial size, the obese hypertensive men had lower serum MR-proANP concentrations (median [interquartile range]: 48.5 [37.0–64.7] pmol/l) compared with the lean normotensive men (69.3 [54.3–82.9] pmol/l), P < 0.01, whereas the obese normotensive men had serum MR-proANP concentrations in between the 2 other groups (54.1 [43.6–62.9] pmol/l). CONCLUSIONS: Despite greater left atrial size, obese hypertensive men have lower circulating MR-proANP concentrations compared with lean normotensive men.
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Men with obesity and hypertension had lower plasma pro-ANP levels than normotensive lean men despite greater sodium intake and larger left atria.
“Men with obesity and hypertension had lower plasma pro ANP levels than normotensive lean men despite greater sodium intake and larger left atria90,91.”
From Obesity, kidney dysfunction and hypertension: mechanistic links (2019) · cites this paper as [91]
Increases in natriuretic peptides associated with high salt intake and volume loading are diminished in obese compared with lean individuals.
“Increases in NPs associated with high salt intake and volume loading are also diminished in obese compared with lean individuals90–92.”
From Obesity, kidney dysfunction and hypertension: mechanistic links (2019) · cites this paper as [91]
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Obesity, kidney dysfunction and hypertension: mechanistic links
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- Authors
- Asferg, C. L., Andersen, U. B., Linneberg, A., Goetze, J. P., & Jeppesen, J. L.
- Affiliations
- University of Copenhagen (DK)
- Corresponding author
- Asferg, Camilla L
- Venue
- American Journal of Hypertension
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-02-17
- Volume
- 31
- Issue
- 6
- Pages
- 645-650
- ISSN
- 0895-7061 (ISSN-L)
- 1941-7225
- OpenAlex
- W2792327491
- Cited by
- 13
- References
- 30
- Citations by year
- 2025: 1 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 1 · 2020: 3 · 2019: 3 · 2018: 1
- FWCI
- 1.51
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Hypertension (publishedVersion)
- PubMed (publishedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Funders
- Danish Heart Foundation
- Novo Nordisk Foundation
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Heart Failure Treatment and Management
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Keywords
- obesity, hypertension, MR-proANP, left atrial size, natriuretic peptides, left atrial enlargement, ambulatory blood pressure, body mass index, men, cardiac remodeling, obesity-related hypertension, left ventricular function, left atrial function, left atrial pressure
- MeSH terms
- Adult, Aged, Blood Pressure, Cross-Sectional Studies, Echocardiography, Heart Atria, Hemodynamics, Humans, Hypertension, Male, Middle Aged, Atrial Natriuretic Factor, Obesity
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