Platelet binding sites and plasma concentration of atrial natriuretic peptide in patients with essential hypertension.

The plasma concentration of atrial natriuretic peptide (ANP) and the density and affinity of binding sites for ANP in platelets was investigated in patients with essential hypertension. Severe hypertensives were studied whilst still on medication. All subjects were ambulatory and were investigated after 3 days on a 135 mmol/day sodium intake. Plasma ANP levels were significantly increased from 13 +/- 1 fmol/ml in healthy normotensive controls to 39 +/- 5 fmol/ml (P less than 0.01) in moderate or severe hypertensives uncontrolled by treatment. Platelet binding sites varied in a non-linear inverse relationship to plasma concentration of ANP (r = -0.76), from 14 +/- 1 fmol per 10(9) platelets in healthy subjects to 8 +/- 1 fmol per 10(9) platelets in severe hypertensives, uncontrolled by treatment, (P less than 0.05). The latter group with elevated plasma ANP and reduced density of ANP platelet sites, had a high incidence of left ventricular hypertrophy and increased left ventricular mass index by echocardiography. When a diuretic was added or stopped, plasma ANP and ANP sites in platelets varied inversely, with lower ANP concentration in plasma and higher density of ANP receptors in platelets when receiving the diuretic. Plasma concentrations of ANP are increased and the density of ANP receptors is decreased in moderate to severe uncontrolled essential hypertensives with left ventricular hypertrophy, but neither parameter differs from those of healthy age-matched volunteers in mild essential hypertension.