title: N-Terminal Pro-Brain Natriuretic Peptide (NT-proBNP) and Risk of Hypertension in the Atherosclerosis Risk in Communities (ARIC) Study.
abstract: BACKGROUND
  Brain natriuretic peptide (BNP) is released by the heart in response to ventricular and auricular wall stress. Release of BNP is traditionally considered part of the body's protective mechanism against pressure overload by inducing vasodilatation and diuresis. More recent evidence demonstrates that BNP also promotes vessel wall stress and preliminary studies suggest that chronic increased levels may increase risk of hypertension. This study aimed to evaluate the prospective association of N-terminal BNP (NT-proBNP), a cleavage product of BNP, with risk of hypertension in the Atherosclerosis Risk in Communities cohort study.
  
  
  METHODS
  We conducted a prospective analysis of 3,798 middle-aged participants in the ARIC study without hypertension at baseline (1996-1998). Using Cox proportional hazards models, we characterized the association between NT-proBNP at baseline and newly diagnosed hypertension for a maximum of 14 years of follow-up (median = 9 years).
  
  
  RESULTS
  We observed 2,113 new hypertension cases over the follow-up period. Higher baseline NT-proBNP was independently associated with an increased risk of hypertension. Adjusted hazard ratios for incident hypertension in the highest quartile compared to the lowest quartile of NT-proBNP at baseline was 1.24 (95% CI: 1.08-1.42). Each log-unit increase in NT-proBNP was associated with an 8% increased risk of hypertension (95% CI: 1.03-1.13).
  
  
  CONCLUSIONS
  Persons with elevated NT-proBNP, even with normal blood pressure at baseline, were at increased risk of developing hypertension. Our results suggest that elevated circulating BNP might contribute to the development of hypertension in previously normotensive individuals.
authors.affiliation: The Ohio State University College of Public Health, Columbus, OH; jbower@cph.osu.edu.
authors.forename: Julie K
authors.initials: JK
authors.lastname: Bower
authors.affiliation: The Johns Hopkins University Bloomberg School of Public Health and the Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD;
authors.forename: Mariana
authors.initials: M
authors.lastname: Lazo
authors.affiliation: The Johns Hopkins University Bloomberg School of Public Health and the Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD;
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Matsushita
authors.affiliation: The Johns Hopkins University Bloomberg School of Public Health and the Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD;
authors.forename: Jonathan
authors.initials: J
authors.lastname: Rubin
authors.affiliation: Baylor College of Medicine, Houston, TX.
authors.forename: Ron C
authors.initials: RC
authors.lastname: Hoogeveen
authors.affiliation: Baylor College of Medicine, Houston, TX.
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
authors.affiliation: The Johns Hopkins University Bloomberg School of Public Health and the Welch Center for Prevention, Epidemiology, and Clinical Research, Baltimore, MD;
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Selvin
mesh_terms: D015331:Cohort Studies; 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*; D018570:Risk Assessment; D014481:United States / Q000453:epidemiology
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: biological markers; blood pressure; brain natriuretic peptide; cohort; epidemiology; hypertension; risk factors.