Hypertensive patients with abnormal diurnal blood pressure variation patterns had significantly higher plasma BNP levels (16.8 pg/mL) compared to those with normal circadian variation (8.4 pg/mL).
Cross-Sectional (n=98)
No
Does an abnormal diurnal blood pressure variation profile associate with elevated plasma BNP levels in asymptomatic hypertensive patients?
Plasma BNP levels are significantly elevated in asymptomatic hypertensive patients with abnormal diurnal blood pressure variation, suggesting its utility as a biomarker for identifying patients at higher cardiovascular risk.
Absolute Event Rate: 16.8% vs 8.4%
p-value: p=<0.01
We examined the relationship between plasma B-type natriuretic peptide (BNP) level and diurnal variability pattern of blood pressure (BP). Twenty-four-hour ambulatory BP monitoring was performed in 98 patients with asymptomatic essential hypertension, and the patients were classified into four groups according to their circadian BP variation profiles: dippers (n=29), nondippers (n=36), extreme dippers (n=19), and risers (n=14). Plasma BNP was measured by enzyme immunoassay. Based on the distribution pattern of BNP values, the values were analyzed after logarithmic transformation. Significant differences in plasma BNP levels among the types of circadian BP variations were demonstrated by analysis of variance (p<0.0005). Nondippers and risers showed significantly higher plasma BNP levels (mean range: -1 SD and +1 SD: 16.1 6.3, 41.6 pg/mL and 29.2 15.9, 53.4 pg/mL, respectively) than dippers (8.4 3.7, 19.1 pg/mL). The area under the receiver operating characteristics curve for distinguishing patients with abnormal circadian BP variation from those with normal variation was 0.72, indicating that plasma BNP levels were useful for distinguishing between these patients. Specificity of 69% and sensitivity of 72% were obtained with a cut-off value of 10.5 pg/mL (log plasma BNP, 1.02) for distinguishing the abnormal diurnal BP profile group from the normal group. In conclusion, hypertensive patients with abnormal diurnal BP variation patterns (nondippers, extreme dippers, and risers) showed higher plasma BNP levels than those with normal circadian BP variation (dippers). Plasma BNP level is clinically useful for the identification of hypertensive patients who have abnormal circadian BP variability, which increases the risk of cardiovascular events.
Nakatsu et al. (Mon,) conducted a cross-sectional in Asymptomatic essential hypertension (n=98). Abnormal diurnal BP variation (nondippers, extreme dippers, risers) vs. Normal diurnal BP variation (dippers) was evaluated on Plasma BNP level (pg/mL) (p=<0.01). Hypertensive patients with abnormal diurnal blood pressure variation patterns had significantly higher plasma BNP levels (16.8 pg/mL) compared to those with normal circadian variation (8.4 pg/mL).