Correlation of N-terminal pro-B-type natriuretic peptide with clinical parameters in patients with hypertension.
OBJECTIVE
Identification of patients with arterial hypertension and a possible onset of heart failure by determining the concentration of N-terminal pro-B-type natriuretic peptide (NT-proBNP) enables timely intensification of treatment and allows clinicians to prescribe and implement optimal and appropriate care. The aim of this study was to evaluate NT-proBNP in patients with longstanding hypertension and in patients with signs of hypertensive cardiomyopathy.


METHODS
The study involved 3 groups, with 50 subjects each: "healthy" persons (control group), patients with hypertension and normal left ventricular systolic function (group 1) and patients with longstanding hypertension and signs of hypertensive cardiomyopathy with impaired left ventricular systolic function (group 2). We measured levels of NT-proBNP, C-reactive protein and creatinine according to the manufacturer's instructions. All the patients were clinically examined including physical examination of the heart with blood pressure, pulse rate, electrocardiogram (ECG) and echocardiogram.


RESULTS
Our results showed that the determined parameters generally differed significantly (Student's t-test) among the groups. The mean (+/- SD) values of NT-proBNP in the control group, group 1 and group 2 were: 2.794 (+/- 1.515) pmol/L, 9.575 (+/- 5.449) pmol/L and 204.60 (84,93) pmol/L, respectively. NT-proBNP correlated significantly with the determined parameters both in the group 1 and the group 2. In the group 1, the highest correlation was obtained with C-reactive protein (r = 0.8424). In the group 2, the highest correlation was obtained with ejection fraction (r = -0.9111). NT-proBNP showed progressive increase in proportion to the New York Heart Association (NYHA) classification. The patients in the- group 2 who belonged to the II and III NYHA class had significantly higher levels of NT-proBNP than those in the NYHA class I (ANOVA test, p = 0.001).


CONCLUSIONS
The obtained results suggest that NT-proBNP is a useful biomarker in the treatment of patients with longstanding hypertension who are at risk for heart failure.
Institute of Medical Biochemistry, Military Medical Academy, Belgrade, Serbia. jpejovic1962@gmail.com
Janko
J
Pejović
Svetlana
S
Ignjatović
Marijana
M
Dajak
Nada
N
Majkić-Singh
Zarko
Z
Vucinić
Miroslav
M
Pavlović
D015415:Biomarkers / Q000097:blood; D002097:C-Reactive Protein / Q000032:analysis; D003404:Creatinine / Q000097:blood; D004452:Echocardiography / Q000379:methods; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006333:Heart Failure / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000517:prevention & control; D006801:Humans; D006973:Hypertension / Q000097:blood / Q000150:complications; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D015203:Reproducibility of Results; D012307:Risk Factors; D012720:Severity of Illness Index; D018487:Ventricular Dysfunction, Left / Q000209:etiology / Q000503:physiopathology
D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain; D002097:C-Reactive Protein; D003404:Creatinine