Brain Natriuretic Peptide Counteracting the Renin-Angiotensin-Aldosterone System in Accelerated-Malignant Hypertension

Abstract Two patients (52 years old woman and 57 years old man) with rapidly progressive hypertension and marked elevation of brain natriuretic peptides (BNP) were presented, who exhibited polyuria, natriuresis, hypokalemia, and posterior reversible encephalopathy syndrome (PRES), left ventricular dysfunction together with retinopathy and nephropathy, which were attenuated in a short time span of 1–2 months with normalization of blood pressure after the anti-hypertensive treatment. The possible role of BNP in the pathophysiology of accelerated-malignant hypertension was discussed together with a review of the literature.