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Brain natriuretic peptide as a risk marker for incident hypertensive cardiovascular events
Makoto Suzuki1, Mareomi Hamada, Kozo Yamamoto
1Ehime Prefectural Central Hospital, Matsuyama, Japan. suzuki-m@mail.netwave.or.jp
Insights
Brain natriuretic peptide (BNP) increases with age and left ventricular hypertrophy. Elevated BNP levels are a significant risk marker for cardiovascular events in hypertensive patients.
Area of Science:
- Cardiology
- Gerontology
- Biomarkers
Background:
- Hypertensive left ventricular hypertrophy is a common complication of hypertension.
- Brain natriuretic peptide (BNP) is a hormone with known cardiovascular effects.
- Aging is associated with changes in cardiovascular function and hormone levels.
Purpose of the Study:
- To investigate the combined effects of aging and hypertensive left ventricular hypertrophy on plasma BNP levels.
- To assess the utility of BNP as a risk marker for incident cardiovascular events in hypertensive individuals.
Main Methods:
- Echocardiographic assessment of left ventricular mass in 185 hypertensive patients and 44 normotensive controls.
- Analysis of the relationship between age and plasma BNP levels across groups.
- 40-month follow-up to identify incident cardiovascular events.
- Multivariate regression and Cox proportional hazards analyses.
Main Results:
- All groups showed a positive correlation between age and BNP.
- The age-BNP relationship was steepest in hypertensive patients with left ventricular hypertrophy.
- Age, pulse pressure, and left ventricular mass index were independently associated with increased BNP.
- BNP demonstrated the highest correlation with incident cardiovascular events (risk ratio=1.011, p=0.0011).
Conclusions:
- BNP levels are synergistically elevated by aging and left ventricular hypertrophy.
- Plasma BNP is a valuable risk marker for predicting cardiovascular events in hypertensive patients.
Abstract:
We examined the effects of aging and hypertensive left ventricular hypertrophy on the plasma level of brain natriuretic peptide (BNP), and assessed BNP as a risk marker for incident hypertensive cardiovascular events. One hundred and eighty-five hypertensive patients were echocardiographically divided into a hypertensive group with normal left ventricular mass (n=96; age range, 37-86 years; left ventricular mass, 97+/-14 g/m2) and a hypertensive group with left ventricular hypertrophy (n=89; 37-90 years; 140+/-20 g/m2). Forty-four normotensive subjects served as the normotensive group (32-84 years; 91+/-15 g/m2). We examined the association of age with BNP in the three groups and also evaluated BNP as a risk marker for incident cardiovascular events by following up all patients for 40 months. All three groups demonstrated a significant positive relationship between age and BNP. The slope of the relation between age and BNP was steepest in the hypertensive group with left ventricular hypertrophy (p<0.0001 vs. the other two groups). Multiple regression analysis revealed that age, pulse pressure and left ventricular mass index were significantly associated with the increase in BNP. Multivariate Cox proportional hazards regression analysis, which was used to assess the potential association of age, pulse pressure, left ventricular mass index and BNP with the cardiovascular events during follow-up, revealed the highest correlation between BNP and incident cardiovascular events (risk ratio=1.011; p=0.0011). BNP, which is synergistically increased with aging and left ventricular hypertrophy, may be an important risk marker for hypertensive cardiovascular events.