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March 16, 2015American Journal of Hypertension39 citationsOpen Access

N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) and Risk of Hypertension in the Atherosclerosis Risk in Communities (ARIC) Study

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JBJulie K. BowerMLMariana LazoKMKunihiro Matsushita

Key Result

Elevated baseline NT-proBNP was associated with an increased risk of developing hypertension in previously normotensive individuals (HR 1.24; 95% CI 1.08-1.42 for highest vs lowest quartile).

Study Design

Type

Cohort (n=3,798)

Multicenter

Yes

Structured PICO

Does elevated baseline NT-proBNP increase the risk of developing incident hypertension in middle-aged normotensive individuals?

P
Population
3,798 middle-aged participants in the Atherosclerosis Risk in Communities (ARIC) study without hypertension at baseline (1996-1998)
I
Intervention
Elevated baseline NT-proBNP levels (highest quartile or per log-unit increase)
C
Comparator
Lower baseline NT-proBNP levels (lowest quartile)
O
Outcome
Newly diagnosed hypertension (incident hypertension) over a maximum of 14 years follow-up

Elevated baseline NT-proBNP is independently associated with an increased risk of developing incident hypertension in previously normotensive middle-aged individuals.

Main Result

Effect estimate: HR 1.24 (95% CI 1.08-1.42)

Abstract

BACKGROUND: Brain natriuretic peptide (BNP) is released by the heart in response to ventricular and auricular wall stress. Release of BNP is traditionally considered part of the body's protective mechanism against pressure overload by inducing vasodilatation and diuresis. More recent evidence demonstrates that BNP also promotes vessel wall stress and preliminary studies suggest that chronic increased levels may increase risk of hypertension. This study aimed to evaluate the prospective association of N-terminal BNP (NT-proBNP), a cleavage product of BNP, with risk of hypertension in the Atherosclerosis Risk in Communities cohort study. METHODS: We conducted a prospective analysis of 3,798 middle-aged participants in the ARIC study without hypertension at baseline (1996-1998). Using Cox proportional hazards models, we characterized the association between NT-proBNP at baseline and newly diagnosed hypertension for a maximum of 14 years of follow-up (median = 9 years). RESULTS: We observed 2,113 new hypertension cases over the follow-up period. Higher baseline NT-proBNP was independently associated with an increased risk of hypertension. Adjusted hazard ratios for incident hypertension in the highest quartile compared to the lowest quartile of NT-proBNP at baseline was 1.24 (95% CI: 1.08-1.42). Each log-unit increase in NT-proBNP was associated with an 8% increased risk of hypertension (95% CI: 1.03-1.13). CONCLUSIONS: Persons with elevated NT-proBNP, even with normal blood pressure at baseline, were at increased risk of developing hypertension. Our results suggest that elevated circulating BNP might contribute to the development of hypertension in previously normotensive individuals.

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Cite This Study

Bower et al. (2015) conducted a cohort in Without hypertension (n=3,798). NT-proBNP vs. Lowest quartile of NT-proBNP was evaluated on Newly diagnosed hypertension (HR 1.24, 95% CI 1.08-1.42). Elevated baseline NT-proBNP was associated with an increased risk of developing hypertension in previously normotensive individuals (HR 1.24; 95% CI 1.08-1.42 for highest vs lowest quartile).

synapsesocial.com/papers/6a15f562557f83931ae3d852https://doi.org/10.1093/ajh/hpv026
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