title: Variability of NT-proBNP and its relationship with inflammatory status in patients with stable essential hypertension: a 2-year follow-up study.
abstract: BACKGROUND
  The variability of NT-proBNP levels has been studied in heart failure, yet no data exist on these changes over time in hypertensive patients. Furthermore, studies on the relationship between natriuretic peptides and inflammatory status are limited.
  
  
  RESULTS
  220 clinically and functionally asymptomatic stable patients (age 59 ± 13, 120 male) out of 252 patients with essential hypertension were followed up, and NT-proBNP was measured at baseline, 12 and 24 months. No differences in NT-proBNP were found with respect to the basal stage in the hypertrophic group, but significant changes were found in non-hypertrophic subjects. The reproducibility of NT-proBNP measurements was better in patients with hypertrophy than in the non-hypertrophic group for the three intervals (stage I-basal; stage II-stage I; stage II-basal) with a reference change value of 34%, 35% and 41%, respectively, in the hypertrophic group. A more elevated coefficient of correlation was obtained in the hypertrophic group than in patients without hypertrophy: basal versus stage I (r = 0.79, p < 0.0001 and r = 0.59, p < 0.0001) and stage I versus stage II (r = 0.86, p < 0.0001 and r = 0.56, p < 0.0001). Finally, levels of NT-proBNP significantly correlated with sTNF-R1 (p < 0.0001) and IL-6 (p < 0.01) during follow-up. A multivariate linear regression analysis showed that sTNF-R1 is an independent factor of NT-proBNP.
  
  
  CONCLUSIONS
  This work shows that there is good stability in NT-proBNP levels in a follow-up study of asymptomatic patients with stable hypertension and left ventricular hypertrophy. As a consequence, assessment of NT-proBNP concentrations may be a useful tool for monitoring the follow-up of hypertensive patients with hypertrophy. Measured variations in peptide levels, exceeding 35% in a 12-month follow-up and 41% in a 24-month follow-up, may indicate an increase in cardiovascular risk, and therefore implies adjustment in the medical treatment. In addition, this study shows a link between neurohormonal and inflammatory activation in these patients.
authors.affiliation: Cardiocirculatory Unit, Research Center, Hospital Universitario La Fe, Valencia, Spain. rivera_jmi@gva.es
authors.forename: Esther
authors.initials: E
authors.lastname: Roselló-Lletí
authors.forename: Jose R
authors.initials: JR
authors.lastname: Calabuig
authors.forename: Pedro
authors.initials: P
authors.lastname: Morillas
authors.forename: Raquel
authors.initials: R
authors.lastname: Cortés
authors.forename: Luis
authors.initials: L
authors.lastname: Martínez-Dolz
authors.forename: Luis
authors.initials: L
authors.lastname: Almenar
authors.forename: Jose R
authors.initials: JR
authors.lastname: González-Juanatey
authors.forename: Catheline
authors.initials: C
authors.lastname: Lauwers
authors.forename: Antonio
authors.initials: A
authors.lastname: Salvador
authors.forename: Manuel
authors.initials: M
authors.lastname: Portolés
authors.forename: Vicente
authors.initials: V
authors.lastname: Bertomeu
authors.forename: Miguel
authors.initials: M
authors.lastname: Rivera
mesh_terms: D000368:Aged; D016207:Cytokines / Q000378:metabolism; D015150:Echocardiography, Doppler / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006973:Hypertension / Q000235:genetics / Q000378:metabolism*; D007249:Inflammation / Q000235:genetics / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000235:genetics*; D010446:Peptide Fragments / Q000235:genetics*; D010455:Peptides / Q000737:chemistry; D018121:Receptors, Cytokine / Q000378:metabolism; D012044:Regression Analysis
chemical_list: D016207:Cytokines; D010446:Peptide Fragments; D010455:Peptides; D018121:Receptors, Cytokine; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain