N-terminal pro-brain natriuretic peptide predicts cardiovascular events in patients with hypertension and left ventricular hypertrophy: a LIFE study.

• Abstract: BACKGROUND: N-terminal pro-brain natriuretic peptide (Nt-proBNP) and N-terminal pro-atrial natriuretic peptide (Nt-proANP) are strong cardiovascular risk markers in patients with chronic heart failure, as well as in the general population. We investigated whether high Nt-proBNP or Nt-proANP could also predict the composite endpoint (CEP) of cardiovascular death, non-fatal stroke or non-fatal myocardial infarction in patients with hypertension and left ventricular (LV) hypertrophy. METHODS: After 2 weeks of placebo treatment, clinical, laboratory and echocardiographic variables were assessed in 183 hypertensive participants in the LIFE echo substudy with electrocardiographic LV hypertrophy. Nt-proBNP and Nt-proANP were measured by immunoassay at baseline. The patients were followed for 60 +/- 5 months. RESULTS: Using Cox regression analysis, the 25 CEP were predicted by ln(Nt-proBNP) (hazard ratio 1.61 per 2.73-fold increase, P < 0.01) as well as ln(Nt-proANP) (hazard ratio 2.93, P < 0.05). Nt-proBNP above the median value of 21.8 pmol/ml was associated with higher incidence of CEP (19.6 versus 7.7%, P < 0.05). Nt-proBNP above the median value was associated with higher incidence of CEP in the 123 patients without history of diabetes or cardiovascular disease (14.8 versus 4.3%, P < 0.05), but the association was insignificant in the 60 patients with a history of diabetes or cardiovascular disease (26.3 versus 18.2%, NS). Nt-proANP showed the same tendency. CONCLUSION: Nt-proBNP, more than Nt-proANP, strongly predicts cardiovascular events in patients with hypertension and LV hypertrophy, especially in patients without diabetes or clinically overt cardiovascular disease.
• Authors: Michael H Olsen, Kristian Wachtell, Christian Tuxen, Eigil Fossum, Lia E Bang, Christian Hall, Hans Ibsen, Jens Rokkedal, Richard B Devereux, Per Hildebrandt (Affiliation: Department of Clinical Physiology and Nuclear Medicine, Glostrup University Hospital, Glostrup, Denmark. mho at dadlnet.dk)
• Journal: Journal of hypertension (J Hypertens) Vol. 22 Issue 8 Pg. 1597-604 (Aug 2004) ISSN: 0263-6352 [Print] England
• PMID: 15257184 (Publication Type: Clinical Trial, Journal Article, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Infective Agents
• Nerve Tissue Proteins
• Peptide Fragments
• pro-brain natriuretic peptide (1-76)
• Natriuretic Peptide, Brain
• Losartan
• Atenolol

Topics

• Aged
• Anti-Infective Agents (administration & dosage)
• Atenolol (administration & dosage)
• Disease-Free Survival
• Female
• Follow-Up Studies
• Humans
• Hypertension (blood, drug therapy, epidemiology)
• Hypertrophy, Left Ventricular (blood, epidemiology, ultrasonography)
• Losartan (administration & dosage)
• Male
• Middle Aged
• Myocardial Infarction (blood, epidemiology)
• Natriuretic Peptide, Brain
• Nerve Tissue Proteins (blood)
• Peptide Fragments (blood)
• Predictive Value of Tests
• Proportional Hazards Models
• Risk Factors
• Stroke (blood, epidemiology)