N-terminal pro-brain natriuretic peptide in arterial hypertension: a valuable prognostic marker of cardiovascular events.
BACKGROUND
N-terminal pro-brain natriuretic peptide (NT-proBNP) provides important prognostic information in patients with chronic heart failure and in the general population. The aim of this study was to evaluate NT-proBNP as a prognostic marker of cardiovascular morbidity and death in a sample of subjects with hypertension and preserved left ventricular systolic function from the general population.


RESULTS
The study population was recruited from 4 general practitioners. The study participants (n = 569 subjects; ages, 50-89 years) completed a heart failure questionnaire and were submitted to blood pressure measurement, electrocardiography, echocardiography, and blood sampling. After exclusion of subjects with left ventricular ejection fraction of <50%, 270 subjects fulfilled the following criteria for hypertension: history of hypertension or blood pressure >150/90 mmHg. During 3 years of follow-up, 28 subjects (10.4%) reached the composite end point of death, stroke/transient ischemic attack, or myocardial infarction. After adjustment for cardiovascular risk factors, NT-proBNP (logarithmically transformed) independently predicted the risk of experiencing a composite end point (hazard ratio, 1.94; P < .0001), and death (hazard ratio, 2.28; P < .0001). The risk of having a composite end point (21 vs 7; P = .005) was significantly higher for subjects with NT-proBNP above the study median than for subjects with NT-proBNP below the study median.


CONCLUSIONS
In this sample of subjects with hypertension and preserved left ventricular systolic function from the general population, plasma NT-proBNP was found to be a valuable cardiovascular risk marker, independently of traditional risk factors and prevalent cardiovascular disease.
Pedersen
Frants
F
Department of Cardiology and Endocrinology, Copenhagen University Hospital, Frederiksberg, Denmark.
Raymond
Ilan
I
Kistorp
Caroline
C
Sandgaard
Niels
N
Jacobsen
Peter
P
Hildebrandt
Per
P
D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D015924:Blood Pressure Monitors; D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000401:mortality; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000175:diagnosis* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D018579:Patient Selection; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D013318:Stroke Volume / Q000502:physiology; D011795:Surveys and Questionnaires
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain