title: Higher serum concentrations of N-terminal pro-B-type natriuretic peptide associate with prevalent hypertension whereas lower associate with incident hypertension.
abstract: BACKGROUND
  The role of the natriuretic peptides (NPs) in hypertension is complex. Thus, a higher blood NP concentration is a robust marker of pressure-induced cardiac damage in patients with hypertension, whereas genetically elevated NP concentrations are associated with a reduced risk of hypertension and overweight individuals presumably at high risk of hypertension have lower NP concentrations.
  
  
  OBJECTIVE
  To investigate the associations between serum N-terminal pro-B-type natriuretic peptide (NT-proBNP), used as a surrogate marker for active BNP, and prevalent as well as 5-year incident hypertension in a Danish general population sample.
  
  
  METHODS
  Cross-sectional and prospective population-based study.
  
  
  RESULTS
  At baseline, among 5,307 participants (51.3% women, mean age 46.0±7.9 years) with a complete set of data, we recorded 1,979 cases with prevalent hypertension (PHT). Among 2,389 normotensive participants at baseline with a complete set of data, we recorded 324 cases with incident hypertension (IHT) on follow-up 5 years later. In models adjusted for age, sex, lifestyle, social, dietary, anthropometric, pulmonic, lipid, metabolic and renal risk factors, as well as heart rate and baseline blood pressure (only incident model), one standard deviation increase in baseline log-transformed NT-proBNP concentrations was on one side associated with a 21% higher risk of PHT (odds ratio [OR]: 1.21 [95% confidence interval (CI): 1.13-1.30], P<0.001), and on the other side with a 14% lower risk of IHT (OR: 0.86 [95%CI:0.76-0.98], P = 0.020).
  
  
  CONCLUSIONS
  Higher serum concentrations of NT-proBNP associate with PHT whereas lower concentrations associate with IHT. This suggests that a lower amount of circulating BNP, resulting in diminished vasodilation and natriuresis, could be involved in the pathogenesis of hypertension in its early stages.
authors: Department of Internal Medicine, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark; Research Centre for Prevention and Health, the Capital Region of Denmark, Glostrup, Denmark.
authors: Ekim
authors: E
authors: Seven
authors: Research Centre for Prevention and Health, the Capital Region of Denmark, Glostrup, Denmark.
authors: Lise L N
authors: LL
authors: Husemoen
authors: Department of Internal Medicine, Holbæk Hospital, University of Copenhagen, Holbæk, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors: Hans
authors: H
authors: Ibsen
authors: Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.
authors: Nele
authors: N
authors: Friedrich
authors: Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany.
authors: Matthias
authors: M
authors: Nauck
authors: Department of Internal Medicine, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors: Kristian
authors: K
authors: Wachtell
authors: Research Centre for Prevention and Health, the Capital Region of Denmark, Glostrup, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Experimental Research, Glostrup Hospital, Glostrup, Denmark.
authors: Allan
authors: A
authors: Linneberg
authors: Department of Internal Medicine, Glostrup Hospital, University of Copenhagen, Glostrup, Denmark; Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
authors: Jørgen L
authors: JL
authors: Jeppesen
mesh_terms: D000328:Adult; D001794:Blood Pressure; D003430:Cross-Sectional Studies; D003718:Denmark / Q000453:epidemiology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000453:epidemiology*; D015994:Incidence; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D015995:Prevalence; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain