ANP and BNP expression is increased in patients with cardiac hypertrophy and CHF; whether the protective role of NPs and the GC-A/NPRA system are activated by reducing the harmful effects of high BP caused by retention of sodium and fluid volume; by inhibiting the RAAS; or as a result of the hypertrophic and/or fibrotic remodeling in the kidney, heart, and vasculature (Cannone et al., 2019; Rubattu et al., 2019). This evidence concerns the gene NPPA and cardiac hypertrophy.