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

Michael H. Olsen, Kristian Wachtell, Christian Tuxen, Eigil Fossum, Lia E. Bang, Christian Hall, Hans Ibsen, Jens Rokkedal, Richard B. Devereux, Per Hildebrandt

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    Abstrakt

    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 In(Nt-proBNP) (hazard ratio 1.61 per 2.73-fold increase, P < 0.01) as well as In(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.

    OriginalsprogEngelsk
    Sider (fra-til)1597-1604
    Antal sider8
    TidsskriftJournal of Hypertension
    Vol/bind22
    Udgave nummer8
    DOI
    StatusUdgivet - 1 aug. 2004

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