title: Arterial stiffness as determinant of increased amino terminal pro-B-type natriuretic peptide levels in individuals with and without cardiovascular disease--the Rotterdam Study.
abstract: OBJECTIVE
  Large artery stiffening has adverse effects on cardiac structure and function and, therefore, may be associated with elevated circulating levels of amino-terminal pro-B-type natriuretic peptide (NT-proBNP).
  
  
  METHODS
  In a large community-dwelling older population (n = 6211, mean age 69.2 years), serum NT-proBNP, brachial pulse pressure (PP) and carotid-femoral pulse wave velocity (cfPWV) were measured.
  
  
  RESULTS
  In individuals without cardiovascular disease (CVD), median NT-proBNP was 6.7 pmol/l in men (n = 2073) and 10.1 pmol/l in women (n = 3085) (P < 0.001). In these individuals, indices of arterial stiffness correlated with NT-proBNP with beta-coefficients for brachial PP and cfPWV of 0.315 and 0.255 in men and 0.233 and 0.232 in women (all P < 0.001). After multivariable adjustment (age, weight, height, mean arterial pressure, heart rate, smoking, diabetes, estimated glomerular filtration rate, total and high-density lipoprotein-cholesterol and use of lipid-lowering and antihypertensive medication), these associations remained significant for brachial PP and cfPWV in men and for brachial PP in women. In multivariable-adjusted models, brachial PP explained 20.3% and cfPWV 10.7% of the variation of NT-proBNP in men and, respectively, 10.8 and 9.4% in women. In patients with prevalent CVD, indices of arterial stiffness and NT-proBNP were unrelated in multivariable-adjusted models.
  
  
  CONCLUSIONS
  Our findings show that arterial stiffness is independently associated with elevated NT-proBNP levels in individuals without prevalent CVD. The association between vascular stiffness and NT-proBNP is stronger in men than in women and absent in individuals with prevalent CVD.
authors.affiliation: Department of Internal Medicine, Section of Pharmacology, Vascular and Metabolic Diseases, Rotterdam, The Netherlands.
authors.forename: Joost H W
authors.initials: JH
authors.lastname: Rutten
authors.forename: Francesco U S
authors.initials: FU
authors.lastname: Mattace-Raso
authors.forename: Germaine C
authors.initials: GC
authors.lastname: Verwoert
authors.forename: Jan
authors.initials: J
authors.lastname: Lindemans
authors.forename: Albert
authors.initials: A
authors.lastname: Hofman
authors.forename: Jacqueline C M
authors.initials: JC
authors.lastname: Witteman
authors.forename: Anton H
authors.initials: AH
authors.lastname: van den Meiracker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D001783:Blood Flow Velocity / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology; D001916:Brachial Artery / Q000502:physiology* / Q000503:physiopathology; D002318:Cardiovascular Diseases / Q000503:physiopathology*; D002339:Carotid Arteries / Q000502:physiology* / Q000503:physiopathology; D015331:Cohort Studies; D004548:Elasticity / Q000502:physiology*; D005260:Female; D005263:Femoral Artery / Q000469:parasitology / Q000502:physiology* / Q000503:physiopathology; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D009426:Netherlands; D010446:Peptide Fragments / Q000097:blood*; D011446:Prospective Studies; D012039:Regional Blood Flow / Q000502:physiology; D012727:Sex Characteristics
chemical_list: D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain