Changes Of Coupling Factor 6 And Brain Natriuretic Peptide 1-76 In Primary Hypertension

Coupling factor 6 (CF6) is the only one inhibiting the synthesis of prostacyclin endogenously up to date, with effect of enhancing blood pressure level. Vascular endothelial cells, which may secret CF6, might be one of the sources of circulating CF6. Brain natriuretic peptide 1-76 (BNP1-76) is the N-terminal fragment of pro-brain natriuretic peptide left by hydrolysis to active BNP. Studies on BNP1-76 are concentrating on the evaluation of heart failure, risk stratification and prognosis of cardiovascular disease. While BNP 1-76 studies in cardiovascular field was put on recently, and CF6 studies was still on the stage of cell culture and animal trial, our study tries to illustrate the characteristics of CF6, BNP 1-76 in primary hypertension clinically.Out-patients in our hospital diagnosed as hypertension according the WHO hypertension criteria (1999) might be enrolled. He or she might be ruled out with any one of the followings: attacks of stroke, angina pectoris, myocardial infarction or heart failure within 6 months; aneurysm or aortic dissection; valvular heart diseases or cardiomyopathy; atrioventricular block above II or sick sinus syndrome, atrial fibrillation; secondary hypertension; pulmonary dysfunction caused by chronic obstructive pulmonary diseases or other diseases; uncontrolled diabetes, with fast blood glucose>11mmol/L, or with such complications as renal disease or peripheral neuropathy; chronic glomerular nephritis, nephrotic syndrome, renal failure or otherdiseases that made serum creatine more than 132umol/L; uncotrolled diseases of thyroid gland; hepatitis, cirrhosis or other conditions that made serum bilirubin more than 1.5 fold of normal value, or AST and/or ALT more than 2 times of normal value; obesity with BMI more than 30kg/m2. There was no need to cease hypotensive medicine or to limit the dietary salt intake specially. Normal control group was established from volunteers. Venous blood sample was drawn from the enrolled patients and controls to detect the plasma CF6, BNPl-76, endothelin and atrial natriuretic peptide (ANP) by ELISA. Serum lipids including total cholesterol, triglycerides, high density lipoprotein cholesterol (HDL), low density lipoprotein cholesterol (LDL) and ultrasonic cardiography (UCG) were performed in hypertensive patients but not in control for economic reason.There were 50 cases (M 23, F 27) in hypertensive group, with age 36~82yr (57.9+9.9yr), BMI25.6+3.0 kg/m2, course 3~28yr. There were 23 case (M 8, F 15) in control group, with age 24-65yr(47.1 + 12.4yr), BMI 24.4+2.7kg/m2. There were no differences in gender ration and BMI between the two groups. Raw data of CF6 and BNPl-76 were not distributed normally and logarithmically transformed for analysis by SPSS 8.0 package.The study was mainly focused on plasma levels of CF6 and BNPl-76, and their relations to age, gender, endothelin, ANP, serum lipids and parameters determined by UCG. Results. 1. The CF6 level was markedly lower than that in control group (118.3 +1.4 ng/L,164.5 +1.2 ng/L, p<0.001).CF6 level did not correlated to age, gender and BMI. The endothelin level and ANP level were higher in hypertensive group than those in control group (67+21ng/L,48+22 ng/L, p<0.001; 115+38ng/L, 96+33ng/L,p<0.05 respectively), and did not correlated to CF6 level. BNPl-76 in hypertensive group was more than that in control group (2041.74 + 1.34ng/L, 1659.59 + 1.55ng/L, p<0.05). BNPl-76 level did not correlated to age in hypertensive group; BNP 1-76 in subgroup aged 50~69yr was more than that in subgroup aged less than 40 yr (p<0.05) and BNPl-76 level was marked correlated to age (r=0.62,p=0.003). BNPl-76 level was not correlated to gender andBMI. 2. In male patients CF6 level was negatively correlated to HDL (r=-0.52, p = 0.015), in female r=-0.62 (p<0.01), but there was no gender difference. Even after being merged, the correlation was still significant 0<0.01). CF6 level did not correlated to TCHO, TG and LDL. The correlation of CF6 to HDL/LDL ratio in female patients was r=-0.575, p<0.05, but not in male,...