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Abstract
The biologic actions of the cardiac peptide hormone atrial natriuretic peptide (ANP)
of vasorelaxation, diuresis and natriuresis, suppression of aldosterone, vasopressin
release, and thirst are the opposite of those of the renin angiotensin system. This
close relationship is further strengthened by the complementary localization of their
receptors in the brain, adrenal gland, vasculature, and kidney. In many physiologic
situations including postural changes, volume expansion, water immersion, high altitude,
and lower body negative pressure, the plasma levels of ANP and angiotensin II change
inversely. In congestive heart failure, renin and aldosterone levels may initially
be suppressed by high levels of ANP. Similarly the low renin levels associated with
increasing age and with elderly hypertensive patients, may be the result of the elevation
of plasma ANP that occurs with aging. ANP may thus be the endogenous antagonist of
the renin angiotensin aldosterone system. These two opposing systems allow fine-tuning
of volume and pressure by the body.