title: Increasing aminoterminal-pro-B-type natriuretic peptide precedes the development of arterial hypertension: the multiethnic study of atherosclerosis.
abstract: BACKGROUND
  Longitudinal associations between the aminoterminal pro-B-type natriuretic peptide (NT-proBNP) and incident hypertension are lacking.
  
  
  METHODS
  We tested associations between baseline NT-proBNP (bNT-proBNP) and change in NT-proBNP (ΔNT-proBNP) (visit 3 NT-proBNP - bNT-proBNP, 3.2 years apart) with incident hypertension (SBP ≥ 140 and/or DBP ≥90 mmHg or taking antihypertensive medications). Incident hypertension was evaluated in 5596 individuals in the Multi-Ethnic Study of Atherosclerosis without hypertension at baseline (53% women, age range 45-84 years without overt cardiovascular disease) and follow-up for 9.5 years and in a subgroup (1550) who had bNT-proBNP less than 100 pg/ml and no hypertension at visit 3. Incident hypertension was regressed (proportional hazards) on quintiles of bNT-proBNP (range) (reference <19.2, 19.3-40.8, 40.9-70.9, 71-135.2, and >135.5) and also on ΔNT-proBNP categories (reference <-10, -10 to 10, >10 to 50, and >50 pg/ml). Hazard ratios were adjusted for age, race, sex, education, diabetes, obesity, left ventricle mass/height, SBP and DBP, interleukin-6, salt intake, estimated glomerular filtration rate, and exercise.
  
  
  RESULTS
  Compared with the reference category, hazard ratios (95% confidence interval) for incident hypertension compared with the first quintile of bNT-proBNP were 1.47 (1.13-1.93), 1.57 (1.18-2.09), 1.52 (1.12-2.06), and 2.36 (1.62-3.41). Hazard ratios for incident hypertension by categories of ΔNT-proBNP from 3.2 to 9.5 years follow-up were 0.98 (0.62-1.56), 1.13 (0.72-1.79), and 1.82 (1.07-3.12).
  
  
  CONCLUSIONS
  The development of hypertension tended to be preceded by elevated levels of bNT-proBNP or a substantial positive ΔNT-proBNP.
authors.affiliation: aSchool of Public Health, Division of Epidemiology & Community Health, University of Minnesota, Minneapolis, Minnesota bStanford University, Stanford cSchool of Medicine, University of California, San Francisco dDivision of Cardiology, University of California, San Diego, California eDivision of Cardiology, Johns Hopkins Bayview Medical Center, Baltimore, Maryland fSchool of Medicine, University of California, San Diego, California gDivision of Cardiology, University of Minnesota, Minneapolis, Minnesota, USA.
authors.forename: Otto A
authors.initials: OA
authors.lastname: Sanchez
authors.forename: David R
authors.initials: DR
authors.lastname: Jacobs
authors.forename: Hossein
authors.initials: H
authors.lastname: Bahrami
authors.forename: Carmen A
authors.initials: CA
authors.lastname: Peralta
authors.forename: Lori B
authors.initials: LB
authors.lastname: Daniels
authors.forename: João A
authors.initials: JA
authors.lastname: Lima
authors.forename: Alan
authors.initials: A
authors.lastname: Maisel
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Duprez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000627:therapeutic use; D015415:Biomarkers; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000188:drug therapy / Q000453:epidemiology; D015994:Incidence; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D011379:Prognosis; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors
chemical_list: D000959:Antihypertensive Agents; D015415:Biomarkers; D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain