title: Plasma brain natriuretic peptide: a biochemical marker of effective blood pressure management?
abstract: OBJECTIVE
  To investigate plasma brain natriuretic peptide (BNP) concentrations in association with blood pressure (BP) at baseline and after antihypertensive drug treatment.
  
  
  METHODS
  We prospectively examined 186 individuals with newly diagnosed essential hypertension without target organ damage, whose mean age was 48.7 +/- 10.9 years. Treatment initiation began with irbesartan 150 mg/day and was doubled at 4 weeks in cases of inadequate BP control. If indicated, at 8-week-follow-up hydrochlorothiazide 12.5 mg alone or with amlodipine 5-10 mg was added. BNP levels were measured at baseline and after 3 months of antihypertensive treatment.
  
  
  RESULTS
  At baseline plasma BNP levels were found to be related to systolic BP (r = 0.27, P < 0.001), independent of age, sex, smoking status, BMI and left ventricular mass index estimated by echocardiography (beta = 11.81, SE = 3.82, P = 0.002). Additionally, higher BNP concentrations were observed in patients with stage 2 hypertension compared with those with stage 1 (median 38.9 vs. 29.9 pg/ml, P = 0.022). Multivariate analysis showed a positive association between BNP and systolic BP variability (beta = 0.03, SE = 0.01, P = 0.034). At follow-up, 64.7% of the participants who had achieved BP control showed decreased BNP levels in contrast to those with poor BP control (median change -14.5 vs. -1.3 and median range from -34.4 to -4.4 vs. -9.6 to 10.9, respectively, P < 0.001).
  
  
  CONCLUSIONS
  In this hypertensive population, increased BNP concentrations are associated with higher BP levels and systolic BP variability. The fall of BNP observed in those who achieved BP control indicates that BNP could be used as a biochemical marker of effective BP control and target organ protection.
authors.affiliation: Fourth Department of Internal Medicine and Unit of Vascular Medicine, Evangelismos State General Hospital, Athens, Greece.
authors.forename: Emmanuel A
authors.initials: EA
authors.lastname: Andreadis
authors.forename: Dimitrios X
authors.initials: DX
authors.lastname: Georgiopoulos
authors.forename: Chara K
authors.initials: CK
authors.lastname: Tzavara
authors.forename: Panagiota M
authors.initials: PM
authors.lastname: Katsanou
authors.forename: Eleni G
authors.initials: EG
authors.lastname: Fragouli
authors.forename: Eugenia M
authors.initials: EM
authors.lastname: Mavrokefalou
authors.forename: Nikolaos A
authors.initials: NA
authors.lastname: Chatzis
authors.forename: Georgia K
authors.initials: GK
authors.lastname: Ifanti
authors.forename: Emmanuel J
authors.initials: EJ
authors.lastname: Diamantopoulos
mesh_terms: D000328:Adult; D000959:Antihypertensive Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D001794:Blood Pressure; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000188:drug therapy; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D011446:Prospective Studies
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers; D020097:Natriuretic Peptide, Brain