Responses of Plasma Catecholamines, Renin-Angiotensin-Aldosterone System, and Atrial Natriuretic Peptide to Exercise in Patients with Essential Hypertension

Neurohormonal responses to exercise have not been studied fully in patients with essential hypertension (HT). This study determined if neurohormonal responses to exercise are altered between three subgroups of HT categorized by basal plasma renin activity (PRA). Plasma norepinephrine, epinephrine, atrial natriuretic peptide (ANP), PRA, angiotensin II (All), and aldosterone were measured at rest and after submaximal treadmill exercise in 39 patients with essential HT (WHO classes I–II) and 13 controls. Patients with HT were divided into three subgroups based on the PRA level [low-renin ( 2.0) HT (n = 12)]. Patients with HT had higher blood pressure during exercise compared to controls, but blood pressure responses were similar among low-, normal-, and high-renin HT. Neurohormonal factors were comparable between all hypertensives and controls, except for higher plasma All at rest in patients with HT. When neurohormones were compared among three subgroups of HT, plasma norepinephrine and epinephrine responses were similar. Patients with high-renin HT had higher PRA and All, and lower ANP levels at rest and after exercise. In all hypertensives, negative correlations were observed between resting PRA and resting ANP (r = -0.41, p