Lack of activation of molecular forms of the BNP system in human grade 1 hypertension and relationship to cardiac hypertrophy.
We evaluated relationships among two circulating molecular forms of brain natriuretic peptide (BNP32 and NT-proBNP), severity of hypertension (HTN), and cardiac hypertrophy in subjects with mild, moderate, and severe HTN. We prospectively studied 78 patients (43 males; mean age 51.4 +/- 11 yr) with essential HTN and 28 age- and sex-matched controls. BNP32 and NT-proBNP were measured by radioimmunoassay. In grade 1 HTN, BNP32 was not elevated and NT-proBNP was reduced (P = 0.030) compared with controls. However, log-transformed values of BNP32 and NT-proBNP were both increased with severity of HTN from grade 1 to 3 (P <0.0001 and P = 0.003, respectively). By multivariate analysis, log BNP32 was independently predicted by age (beta = 0.210, P = 0.026) and HTN grade (beta = 0.274, P = 0.004), whereas log NT-proBNP was independently predicted by sex (beta = 0.235, P = 0.012) and HTN grade (beta = 0.218, P = 0.0023). Two forms of BNP were measured in normal subjects and patients with essential HTN. In grade 1 HTN, BNP32 was unchanged and NT-proBNP was significantly reduced compared with controls. As severity increased in humans with grade 1 to 3 HTN, both BNP32 and NT-proBNP levels were increased while not being affected by the presence of left ventricular hypertrophy. The lack of activation of BNP32 together with the reduction of NT-proBNP in grade 1 HTN may represent an impaired response of the BNP system in the early phase of HTN. The later activation of both forms of BNP may be a late compensatory effect, because it correlates with severity of HTN rather than cardiac hypertrophy/remodeling.
Belluardo
Paola
P
Cardiorenal Research Laboratory, 200 First St., SW, Rochester, MN 55905, USA. cataliotti.alessandro@mayo.edu
Cataliotti
Alessandro
A
Bonaiuto
Lorena
L
Giuffrè
Eliana
E
Maugeri
Egle
E
Noto
Paola
P
Orlando
Giovanna
G
Raspa
Giuseppa
G
Piazza
Brigida
B
Babuin
Luciano
L
Chen
Horng H
HH
Martin
Fernando L
FL
McKie
Paul M
PM
Heublein
Denise M
DM
Burnett
John C
JC
Malatino
Lorenzo S
LS
D001794:Blood Pressure / Q000502:physiology; D006332:Cardiomegaly / Q000097:blood* / Q000503:physiopathology*; D004452:Echocardiography; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000503:physiopathology*; D017379:Hypertrophy, Left Ventricular / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D012720:Severity of Illness Index; D020257:Ventricular Remodeling / Q000502:physiology
D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain