Plasma brain natriuretic peptide concentration: impact of age and gender.
OBJECTIVE
We wished to examine the effects of age and gender on plasma brain natriuretic peptide (BNP) concentration in a population-based study.


BACKGROUND
Measurement of BNP concentration is approved for use in the diagnosis of heart failure and may aid in the detection of left ventricular dysfunction. Although BNP is approved for clinical use, there are few data regarding the range of BNP observed in persons without cardiovascular disease or cardiac dysfunction. These data are essential for the interpretation of BNP.


METHODS
In 2,042 randomly selected residents of Olmsted County, Minnesota, >44 years old, BNP (Shionogi and Biosite assays), Doppler echocardiography, and medical record review were performed. A normal subset of subjects (n = 767) in sinus rhythm without cardiovascular, renal, or pulmonary disease or diabetes; on no cardiovascular medications; and with normal systolic, diastolic, and valvular function was identified.


RESULTS
Within the normal subset, the distribution of BNP differed by age, gender, and assay system. With both assays, BNP increased significantly with age and was significantly higher in women than men, leading to age-, gender-, and assay-specific reference ranges. Receiver operating characteristic analysis for the ability of BNP to detect an ejection fraction < or = 40% was performed in each age/gender stratum in the entire cohort (n = 2,042) and confirmed that discriminatory values for BNP for detection of reduced ejection fraction were higher in women and older persons and were different between the two assays.


CONCLUSIONS
Interpretation of BNP should include consideration of age-, gender-, and assay-specific partition values.
Redfield
Margaret M
MM
Division of Cardiovascular Diseases, Mayo Clinic and Foundation, Rochester, Minnesota 55905, USA. redfield.margaret@mayo.edu
Rodeheffer
Richard J
RJ
Jacobsen
Steven J
SJ
Mahoney
Douglas W
DW
Bailey
Kent R
KR
Burnett
John C
JC
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D012372:ROC Curve; D012737:Sex Factors
D020097:Natriuretic Peptide, Brain