Key result
Peripheral arterial disease in men is linked to ~2.5-fold higher NT-proBNP levels versus controls.
Why the study?
The relation of NT-proBNP to ambulatory blood pressure and hypertensive target organ damage in high-risk patients with peripheral arterial disease had not been studied.
Case-Control (n=199)
Suggests night pulse pressure may indicate subclinical cardiac strain in peripheral arterial disease; leaves open whether targeting.
BACKGROUND: Increased levels of N-terminal prohormone brain natriuretic peptide (NT-proBNP) are associated with left ventricular dysfunction (LVD) and left ventricular hypertrophy (LVH), but the relation of NT-proBNP to ambulatory blood pressure (ABP) and hypertensive target organ damage in high-risk patients with peripheral arterial disease (PAD) has not been studied. We hypothesized that NT-proBNP levels were increased in patients with PAD in comparison to a matched control group and that levels of NT-proBNP were related to ABP. METHODS: Blood samples were analysed for NT-proBNP in 103 males with PAD and 96 age- and sex-matched controls. Ninety-eight PAD patients performed ABP monitoring and 99 underwent Tc-99m Sestamibi myocardial perfusion SPECT. RESULTS: NT-proBNP was significantly increased in PAD patients compared with controls [median (interquartiles)] 167(76, 418) vs 68(38, 142) pg/ml, p<0.001. Plasma levels of NT-proBNP correlated positively to systolic blood pressure (SBP), pulse pressure (PP), night-day ratio of SBP and showed the strongest correlation to average night PP (r=0.42, p<0.001). In multiple regression analysis, night PP remained independently related to NT-proBNP. CONCLUSION: NT-proBNP levels are markedly increased in PAD patients compared to age-matched controls. Night PP is related to NT-proBNP levels independently of other variables highlighting the importance of ambulatory PP as a cardiovascular risk factor. Measurement of NT-proBNP could be indicated in PAD patients for further risk stratification.
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Svensson et al. (2005) conducted a case-control in Peripheral arterial disease (n=199). Peripheral arterial disease vs. Age- and sex-matched controls was evaluated on NT-proBNP concentration (pg/ml) (p=<0.001). Male patients with peripheral arterial disease had significantly higher median NT-proBNP levels compared to matched controls (167 vs 68 pg/ml, P<0.001), which independently correlated with night pulse pressure.
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