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Plasma brain natriuretic peptide: a biochemical marker of effective blood pressure management?
Emmanuel A Andreadis1, Dimitrios X Georgiopoulos, Chara K Tzavara
1Fourth Department of Internal Medicine and Unit of Vascular Medicine, Evangelismos State General Hospital, Athens, Greece.
Insights
Plasma brain natriuretic peptide (BNP) levels correlate with higher blood pressure (BP) and its variability in hypertensive patients. Effective BP control through antihypertensive drugs leads to a significant decrease in BNP levels.
Area of Science:
- Cardiology
- Hypertension Research
- Biomarker Discovery
Background:
- Essential hypertension is a major risk factor for cardiovascular disease.
- Brain natriuretic peptide (BNP) is a hormone involved in cardiovascular regulation.
- Understanding BNP's role in hypertension can aid in diagnosis and treatment monitoring.
Purpose of the Study:
- To investigate the association between plasma brain natriuretic peptide (BNP) concentrations and blood pressure (BP) in patients with newly diagnosed essential hypertension.
- To assess changes in BNP levels following antihypertensive drug treatment.
- To evaluate BNP as a potential biomarker for BP control and target organ protection.
Main Methods:
- Prospective study of 186 individuals with newly diagnosed essential hypertension.
- Antihypertensive treatment initiated with irbesartan, with potential addition of hydrochlorothiazide and/or amlodipine.
- Plasma BNP levels measured at baseline and after 3 months of treatment.
Main Results:
- Baseline plasma BNP levels positively correlated with systolic BP (r=0.27, P<0.001) and systolic BP variability (beta=0.03, P=0.034).
- Higher BNP concentrations were observed in patients with stage 2 hypertension compared to stage 1 (median 38.9 vs. 29.9 pg/ml, P=0.022).
- Achieving BP control after 3 months of treatment led to decreased BNP levels in 64.7% of participants (P<0.001).
Conclusions:
- Elevated plasma BNP concentrations are associated with higher BP levels and increased systolic BP variability in hypertensive individuals.
- A significant reduction in BNP levels was observed in patients who achieved effective BP control.
- BNP may serve as a valuable biochemical marker for monitoring BP control and assessing target organ protection in hypertension management.
Objective:
To investigate plasma brain natriuretic peptide (BNP) concentrations in association with blood pressure (BP) at baseline and after antihypertensive drug treatment.
Patients And Methods:
We prospectively examined 186 individuals with newly diagnosed essential hypertension without target organ damage, whose mean age was 48.7 +/- 10.9 years. Treatment initiation began with irbesartan 150 mg/day and was doubled at 4 weeks in cases of inadequate BP control. If indicated, at 8-week-follow-up hydrochlorothiazide 12.5 mg alone or with amlodipine 5-10 mg was added. BNP levels were measured at baseline and after 3 months of antihypertensive treatment.
Results:
At baseline plasma BNP levels were found to be related to systolic BP (r = 0.27, P < 0.001), independent of age, sex, smoking status, BMI and left ventricular mass index estimated by echocardiography (beta = 11.81, SE = 3.82, P = 0.002). Additionally, higher BNP concentrations were observed in patients with stage 2 hypertension compared with those with stage 1 (median 38.9 vs. 29.9 pg/ml, P = 0.022). Multivariate analysis showed a positive association between BNP and systolic BP variability (beta = 0.03, SE = 0.01, P = 0.034). At follow-up, 64.7% of the participants who had achieved BP control showed decreased BNP levels in contrast to those with poor BP control (median change -14.5 vs. -1.3 and median range from -34.4 to -4.4 vs. -9.6 to 10.9, respectively, P < 0.001).
Conclusion:
In this hypertensive population, increased BNP concentrations are associated with higher BP levels and systolic BP variability. The fall of BNP observed in those who achieved BP control indicates that BNP could be used as a biochemical marker of effective BP control and target organ protection.
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