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Substantial intraindividual variability of BNP concentrations in patients with hypertension

D Conen1, M Pfisterer, B Martina

  • 1Department of Cardiology, University Hospital, Basel, Switzerland. conend@uhbs.ch

Journal of Human Hypertension
|February 18, 2006
PubMed

Insights

Plasma B-type natriuretic peptide (BNP) levels show significant day-to-day variability in individuals. This high intraindividual variability may limit the use of single BNP measurements for accurate cardiovascular risk prediction in individual patients.

Area of Science:

  • Cardiovascular Medicine
  • Biomarkers
  • Clinical Chemistry

Background:

  • Plasma B-type natriuretic peptide (BNP) concentrations are established predictors of mortality and cardiovascular events.
  • Intraindividual variability in BNP levels could potentially confound risk prediction accuracy.

Purpose of the Study:

  • To investigate the intraindividual variability of plasma BNP concentrations.
  • To assess the impact of this variability on cardiovascular risk stratification.

Main Methods:

  • Consecutive outpatients with uncontrolled hypertension (BP ≥ 140/90 mmHg) and not on antihypertensive therapy were enrolled.
  • Plasma BNP levels were measured twice for each patient using the same assay, with a median interval of 10 days.
  • Patients with renal insufficiency, structural heart disease (except LVH), or severe comorbidities were excluded.

Main Results:

  • A total of 77 patients (55% male, mean age 54 years) were included.
  • Median BNP concentrations were similar between the two visits (17 pg/ml vs. 16 pg/ml, P=0.48).
  • However, 44% of patients exhibited an absolute BNP difference of ≥ 10 pg/ml, and 32% shifted BNP tertiles between visits.

Conclusions:

  • While BNP levels are useful for risk assessment at a population level, significant intraindividual variability challenges its utility for individual patient risk stratification.
  • Caution is advised when interpreting single BNP values, particularly those below established heart failure thresholds.

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