Abstract 1682: Hypertension is Associated With Increased BNP and NT-proBNP During 10-Year Follow-up: Results of the Longitudinal MONICA/KORA Survey
BNP and NT-proBNP are strong markers of heart failure but are likewise associated with cardiac remodeling and hypertrophy. In the current study, we assessed for the first time the time-course of BNP and NT-proBNP in the general population during a 10 year follow-up. Subjects (1005 men and women, aged 25 to 74 years) originated from a gender- and age-stratified sample of German residents of the Augsburg area (MONICA/KORA cohort). All subjects underwent physical examination including blood pressure recording at baseline and at follow-up 10 years later. BNP (shionoria) and NT-proBNP (elecsys NT-proBNP) were measured from EDTA-plasma and measurements from both surveys (baseline and follow-up) were available for 871 subjects. During follow-up, (i.e. as an effect of ageing by 10 years) BNP increased by + 13 % from 6.0 pg/ml (median, IQR 2.4 –11.3) to 6.8 (median, IQR 2.0 –17.1) and NT-proBNP by + 28 % from 43.8 pg/ml (median, IQR 26.5–74.6) to 55.9 (median, IQR 30.3–113.7) in subjects with normal blood pressure at baseline (BP, mean 120.5/75.0 mmHg, n = 545). In contrast, subjects with baseline hypertension (mean 149.7/89.6 mmHg, n = 323) were characterized by significantly higher BNP and NT-proBNP at baseline and displayed a significantly greater increase of + 36% BNP from 9.4 pg/ml (IQR 4.4 –16.0) to 12.8 pg/ml (IQR 4.4 –39.5, p < 0.05) and + 57% NT-proBNP from 57.5 pg/ml (IQR 33.5–100.2) to 90.0 pg/ml (IQR 44.4 –197.6, p < 0.05) upon follow-up. The current data demonstrate for the first time that arterial hypertension is associated with significant long-term increases of the cardiac markers BNP and NT-proBNP even if baseline plasma concentrations are in the normal and/or low range. Further, age-related increases of both cardiac markers may at least partially reflect the sequelae of hypertension on cardiac remodeling since only moderate increases of plasma concentrations are observed in the absence of hypertension.