Assessment of B-type natriuretic peptide (BNP) and n-terminal (NT)-probnp in hypertensive patients with heart failure

B-type natriuretic peptide (BNP) and N-terminal proBNP (NT-proBNP) are plasma biomarkers used in patients with heart failure (HF). Hypertension still remains an important, direct or undirect, cause of heart failure (HF). Aim of the study was to evaluate if there are differences in the performance of BNP versus NT-proBNP in monitoring hypertensive patients with heart failure. We evaluated 59 consecutive patients with clinical or instrumental signs of HF, of which 40 had hystory of hypertension (21 M, 19 F, mean age 74 years, range 54–86). 20 patients were in NYHA class I, 14 in NYHA II, 5 in NYHA III, and 1 in NYHA IV. In all patients we tested BNP using the Centaur analyzer (Bayer Diag., Tarrytown, New York, and NT-proBnp using the Elecsys 2010 analyzer (Roche Diagnostic, Indianapolis, Indiana). All assays were performed following the manufacturer's recommendations after one hour of clinostatic position. In all patients an echocardiography was also performed and ejection fraction (EF) was determined. The results are presented in the Table. BNP and NT-proBNP concentrations in different NYHA class p < 0.0001 vs NYHA class III; pts = patients; ns = not significant; no differences between NYHA I and II (NYHA IV did not enter in the analysis because it was represented by only one patient). BNP and NT-proBNP concentrations in different NYHA class p < 0.0001 vs NYHA class III; pts = patients; ns = not significant; no differences between NYHA I and II (NYHA IV did not enter in the analysis because it was represented by only one patient). Both BNP and NT-proBNP were consensually higher in patients with more severe HF, with significant differences between NYHA class I and III, and between NYHA class II and III (NYHA class IV did not enter in the analysis, because there was only 1 patient). Even if EF was considered, both BNP and NT-proBNP significantly correlated with EF, with the highest values in patients with the worst left ventricular dysfunction (r=0.25, p<0.0001 between EF and NT-proBNP; r=0.11, p<0.05 between EF and BNP). Moreover, no differences were observed between two method of assessment of natriuretic peptides, with a significant correlation between BNP and NT-proBNP determination (r=0.71, p<0.0001). In conclusion, either BNP or NT-proBNP can be considered comparable plasma biomarkers to identify and to stratify HF also in hypertensive patients.