title: Racial differences in circulating natriuretic peptide levels: the atherosclerosis risk in communities study.
abstract: BACKGROUND
  Natriuretic peptides promote natriuresis, diuresis, and vasodilation. Experimental deficiency of natriuretic peptides leads to hypertension (HTN) and cardiac hypertrophy, conditions more common among African Americans. Hospital-based studies suggest that African Americans may have reduced circulating natriuretic peptides, as compared to Caucasians, but definitive data from community-based cohorts are lacking.
  
  
  RESULTS
  We examined plasma N-terminal pro B-type natriuretic peptide (NTproBNP) levels according to race in 9137 Atherosclerosis Risk in Communities (ARIC) Study participants (22% African American) without prevalent cardiovascular disease at visit 4 (1996-1998). Multivariable linear and logistic regression analyses were performed adjusting for clinical covariates. Among African Americans, percent European ancestry was determined from genetic ancestry informative markers and then examined in relation to NTproBNP levels in multivariable linear regression analysis. NTproBNP levels were significantly lower in African Americans (median, 43 pg/mL; interquartile range [IQR], 18, 88) than Caucasians (median, 68 pg/mL; IQR, 36, 124; P<0.0001). In multivariable models, adjusted log NTproBNP levels were 40% lower (95% confidence interval [CI], -43, -36) in African Americans, compared to Caucasians, which was consistent across subgroups of age, gender, HTN, diabetes, insulin resistance, and obesity. African-American race was also significantly associated with having nondetectable NTproBNP (adjusted OR, 5.74; 95% CI, 4.22, 7.80). In multivariable analyses in African Americans, a 10% increase in genetic European ancestry was associated with a 7% (95% CI, 1, 13) increase in adjusted log NTproBNP.
  
  
  CONCLUSIONS
  African Americans have lower levels of plasma NTproBNP than Caucasians, which may be partially owing to genetic variation. Low natriuretic peptide levels in African Americans may contribute to the greater risk for HTN and its sequalae in this population.
authors.affiliation: Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (D.K.G., Q.W.).
authors.forename: Deepak K
authors.initials: DK
authors.lastname: Gupta
authors.affiliation: Brigham and Women's Hospital, Harvard Medical School, Boston, MA (B.C., S.C., S.D.S.).
authors.forename: Brian
authors.initials: B
authors.lastname: Claggett
authors.affiliation: Vanderbilt Heart and Vascular Institute, Vanderbilt University Medical Center, Nashville, TN (D.K.G., Q.W.).
authors.forename: Quinn
authors.initials: Q
authors.lastname: Wells
authors.affiliation: Brigham and Women's Hospital, Harvard Medical School, Boston, MA (B.C., S.C., S.D.S.).
authors.forename: Susan
authors.initials: S
authors.lastname: Cheng
authors.affiliation: Department of Epidemiology, Johns Hopkins University, Baltimore, MD (M.L., E.S., J.C.).
authors.forename: Man
authors.initials: M
authors.lastname: Li
authors.affiliation: Department of Medicine, Johns Hopkins University, Baltimore, MD (N.M., E.S.).
authors.forename: Nisa
authors.initials: N
authors.lastname: Maruthur
authors.affiliation: Department of Epidemiology, Johns Hopkins University, Baltimore, MD (M.L., E.S., J.C.) Department of Medicine, Johns Hopkins University, Baltimore, MD (N.M., E.S.).
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Selvin
authors.affiliation: Department of Epidemiology, Johns Hopkins University, Baltimore, MD (M.L., E.S., J.C.).
authors.forename: Josef
authors.initials: J
authors.lastname: Coresh
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of Minnesota, Minneapolis, MN (S.K.).
authors.forename: Suma
authors.initials: S
authors.lastname: Konety
authors.affiliation: Division of Geriatrics, Department of Medicine, University of Mississippi, Jackson, MS (K.R.B., T.M.).
authors.forename: Kenneth R
authors.initials: KR
authors.lastname: Butler
authors.affiliation: Division of Geriatrics, Department of Medicine, University of Mississippi, Jackson, MS (K.R.B., T.M.).
authors.forename: Thomas
authors.initials: T
authors.lastname: Mosley
authors.affiliation: Division of Epidemiology and Public Health, University of Texas-Houston, Houston, TX (E.B.).
authors.forename: Eric
authors.initials: E
authors.lastname: Boerwinkle
authors.affiliation: Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine and Houston Methodist Debakey Heart and Vascular Center, Houston, TX (R.H., C.M.B.).
authors.forename: Ron
authors.initials: R
authors.lastname: Hoogeveen
authors.affiliation: Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine and Houston Methodist Debakey Heart and Vascular Center, Houston, TX (R.H., C.M.B.).
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
authors.affiliation: Brigham and Women's Hospital, Harvard Medical School, Boston, MA (B.C., S.C., S.D.S.).
authors.forename: Scott D
authors.initials: SD
authors.lastname: Solomon
mesh_terms: D001741:Black or African American / Q000208:ethnology / Q000235:genetics*; D050197:Atherosclerosis / Q000453:epidemiology / Q000208:ethnology* / Q000235:genetics; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology / Q000208:ethnology* / Q000235:genetics; D008297:Male; D008875:Middle Aged; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D012111:Residence Characteristics / Q000706:statistics & numerical data; D012307:Risk Factors; D044465:White People / Q000208:ethnology / Q000235:genetics*
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: ancestry informative markers; deficiency; hypertension; natriuretic peptide; race