Abstract MP13: N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) and Risk of Hypertension in the Atherosclerosis Risk in Communities (ARIC) Study
Introduction: Increased plasma N-terminal pro-brain natriuretic peptide (NT-proBNP) concentration reflects cardiac overload and is used to diagnose and stage congestive heart failure. While NT-proBNP exhibits beneficial effects on the cardiovascular system via vasodilatation and diuresis, increased amounts of circulating NT-proBNP also promote release of norepinephrine, which is known to affect blood pressure. Cross-sectional studies report positive associations of NT-pro-BNP with blood pressure, but the prospective association of increased NT-proBNP with risk of hypertension is not well characterized. Thus, the study aim was to evaluate the association of NT-proBNP with incident hypertension in the community-based ARIC Study.
Methods: We conducted a prospective cohort analysis of 3,849 participants aged 53-75 years with measured NT-proBNP at ARIC Visit 4 (1996-98) and normal blood pressure; participants with a history of hypertension (medication use or measured BP ≥140/90 mmHg), cardiovascular disease, or heart failure at baseline were excluded. Incident hypertension was defined based on diagnosis or antihypertensive medication use reported during annual follow-up.
Results: During a median follow-up of 9 years, there were 2,157 new hypertension cases. There was a significant independent positive association between NT-proBNP levels and risk of hypertension. A 10% increased risk of hypertension was observed per log-unit increase in NT-proBNP (Table). This association was similar among individuals who were normotensive and pre-hypertensive at baseline [HR (95 % CI): 1.08 (1.01-1.15) and 1.11 (1.00-1.24), respectively]. Participants in the highest quartile for NT-proBNP were at 26% increased risk compared to those in the lowest quartile.
Conclusions: NT-proBNP is positively associated with incident hypertension in this community-based cohort of middle-aged and older adults. In spite of the vasodilatory effects of increased NT-proBNP, elevated levels predict the development of hypertension.
Author Disclosures: J.K. Bower: None. M. Lazo: None. J. Rubin: None. K. Matsushita: None. R.C. Hoogeveen: None. C.M. Ballantyne: None. E. Selvin: None.
- © 2014 by American Heart Association, Inc.