Abstract 1615: Is Plasma B-type Natriuretic Peptide Measurement Valid for Prediction of Cardiovascular Events and Death in Obese Subjects?
BACKGROUND: Circulating levels of B-type natriuretic peptide (BNP) have been reported to be relatively low in obese individuals, and this humoral dysfunction may be a mechanism linking obesity to the development of cardiovascular disease (CVD). It remains unknown whether plasma BNP might be a reliable biomarker for predicting onset of CVD in obese subjects.
METHODS: Baseline data including body mass index (BMI) and plasma BNP levels were determined in obese subjects selected from a community-based population with no history of CVD (n=4,973; mean age=63 +/− 10 yrs). Obesity was defined as BMI > = 25. CVD was surveyed prospectively.
RESULTS: During follow-up (13,500 person-years), 130 CVD events (heart failure, stroke, myocardial infarction, sudden death) were recorded. The cohort was divided into quartiles according to plasma BNP levels and the crude incidence of CVD was calculated. CVD incidence was lowest in the first quartile (Figure⇓, line). The association between plasma BNP levels and CVD was assessed by Cox proportional hazards regression models. After adjustment for established CVD risks, the hazard ratio (HR) for CVD increased significantly according to quartile levels of plasma BNP (p for trend <0.02), and the HR for the fourth quartile was elevated compared to the first BNP quartile (HR=2.54, 95% CI; 1.32– 4.88: p<0.005) (Figure⇓, columns).
CONCLUSIONS: Decreased circulating BNP levels are unlikely to be a risk factor for future onset of CVD in the obese population. Conversely, elevated plasma BNP is a useful predictor for the onset of CVD in apparently healthy obese subjects within the general population.