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N-terminal pro-brain natriuretic peptide and cognitive decline in older adults at high cardiovascular risk.

AbstractOBJECTIVE:
Elevated levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) are associated with cognitive impairment, which might be explained by cardiovascular diseases or risk factors. The aim of this study was to investigate the association of NT-proBNP with cognitive function and decline in older adults at high risk of cardiovascular disease.
METHODS:
We studied 5,205 men and women (mean age = 75 years) who were recruited into the PROspective Study of Pravastatin in the Elderly at Risk. All participants had pre-existing cardiovascular disease or risk factors thereof. Four domains of cognitive function were tested at baseline and repeated during a follow-up period of 3.2 years.
RESULTS:
Participants with higher NT-proBNP (≥450ng/l) had worse baseline cognitive function, including reaction time (mean difference high vs low group = 3.07 seconds, 95% confidence interval [CI] = 0.83 to 5.32), processing speed (-1.02 digits coded, 95% CI = -1.65 to -0.39), and immediate memory (-0.13 pictures remembered, 95% CI = -0.29 to 0.04). There was no significant difference in delayed memory (-0.14, 95% CI = -0.38 to 0.10) between the NT-proBNP groups. Participants with higher NT-proBNP had a steeper cognitive decline, including reaction time (mean annual change high vs low group = 0.60 seconds, 95% CI = 0.14 to 1.07), processing speed (-0.15 digits coded, 95% CI = -0.25 to -0.05), immediate memory (-0.05 pictures remembered, 95% CI = -0.09 to 0.00), and delayed memory (-0.05 pictures remembered, 95% CI = -0.11 to 0.01). Associations were independent of cardiovascular diseases and risks.
INTERPRETATION:
Higher NT-proBNP associates with worse cognitive function and steeper cognitive decline, independent of cardiovascular diseases and risks. Further studies to unravel the underlying mechanisms are warranted.
AuthorsLiselotte W Wijsman, Behnam Sabayan, Peter van Vliet, Stella Trompet, Wouter de Ruijter, Rosalinde K E Poortvliet, Petra G van Peet, Jacobijn Gussekloo, J Wouter Jukema, David J Stott, Naveed Sattar, Ian Ford, Rudi G J Westendorp, Anton J M de Craen, Simon P Mooijaart
JournalAnnals of neurology (Ann Neurol) Vol. 76 Issue 2 Pg. 213-22 (Aug 2014) ISSN: 1531-8249 [Electronic] United States
PMID24942833 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)
Copyright© 2014 American Neurological Association.
Chemical References
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain
Topics
  • Aged
  • Aged, 80 and over
  • Cardiovascular Diseases (blood)
  • Cognition Disorders (blood)
  • Female
  • Humans
  • Male
  • Natriuretic Peptide, Brain (blood)
  • Peptide Fragments (blood)
  • Randomized Controlled Trials as Topic
  • Risk

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