Association of N-Terminal Pro B-Type Natriuretic Peptide With Blood Pressure and Pulse Pressure in Elderly People　― A Cross-Sectional Population Study ―

Sasaki, Nobuo; Yamamoto, Hideya; Ozono, Ryoji; Fujiwara, Saeko; Kihara, Yasuki

doi:10.1253/circj.cj-18-0031

Cited by 8 publications

(4 citation statements)

References 33 publications

(28 reference statements)

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“…The latter increases with age independently of mean BP or any other determinant factors. Sasaki et al have shown that NT‐proBNP concentrations may be a marker of not only ventricular dysfunction, but also arterial stiffness in the older population without CVD disease. NT‐proBNP was positively associated with SBP, whereas a U‐shaped association was found between DBP and NT‐proBNP.…”

Section: Pathophysiology and Complications Of Hypertension In Older Amentioning

confidence: 99%

Hypertension in older adults: Assessment, management, and challenges

Oliveros

Patel

Kyung

et al. 2019

Clinical Cardiology

251

149

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Hypertension in older adults is related to adverse cardiovascular outcomes, such as heart failure, stroke, myocardial infarction, and death. The global burden of hypertension is increasing due to an aging population and increasing prevalence of obesity, and is estimated to affect one third of the world's population by 2025. Adverse outcomes in older adults are compounded by mechanical hemodynamic changes, arterial stiffness, neurohormonal and autonomic dysregulation, and declining renal function. This review highlights the current evidence and summarizes recent guidelines on hypertension, pertaining to older adults. Management strategies for hypertension in older adults must consider the degree of frailty, increasingly complex medical comorbidities, and psycho‐social factors, and must therefore be individualized. Non‐pharmacological lifestyle interventions should be encouraged to mitigate the risk of developing hypertension, and as an adjunctive therapy to reduce the need for medications. Pharmacological therapy with diuretics, renin‐angiotensin system blockers, and calcium channel blockers have all shown benefit on cardiovascular outcomes in older patients. Given the economic and public health burden of hypertension in the United States and globally, it is critical to address lifestyle modifications in younger generations to prevent hypertension with age.

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Section: Pathophysiology and Complications Of Hypertension In Older Amentioning

confidence: 99%

Hypertension in older adults: Assessment, management, and challenges

Oliveros

Patel

Kyung

et al. 2019

Clinical Cardiology

251

149

View full text Add to dashboard Cite

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“…An increase in NT-proBNP was associated with increasing pressures while the most robust decrease in NT-proBNP across visits corresponded with significant reduction in SBP between these visits. Prior studies have found that SBP is positively associated with NT-proBNP and mediates association with CVD events . Although the observational nature of our study prevents determination of causality, previous clinical trials have established the importance of blood pressure control in the reduction of HF risk .…”

Section: Discussionmentioning

confidence: 78%

Association of Long-term Change in N-Terminal Pro–B-Type Natriuretic Peptide With Incident Heart Failure and Death

et al. 2023

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ImportanceMost studies, especially in primary prevention patients, have evaluated N-terminal B-type natriuretic peptide (NT-proBNP) at one time point. Evaluation of change in NT-proBNP may improve risk stratification for incident cardiovascular events.ObjectiveTo assess the association between change in NT-proBNP and risk for incident heart failure (HF) and death.Design, Setting, and ParticipantsParticipants were recruited from 4 US communities enrolled in the Atherosclerosis Risk in Community (ARIC) study. Individuals who attended ARIC visits 2 and 4 (approximately 6 years apart) with measurements of NT-proBNP and without prevalent HF were included. Assays of NT-proBNP were conducted between 2011 and 2013, and analysis took place between July 2021 and October 2022.ExposuresThe primary exposure variable was NT-proBNP change between visits 2 and 4, modeled as change categories (&lt;125 pg/mL or ≥125 pg/mL) and as percent change.Main Outcomes and MeasuresThe primary outcome measures were incident HF hospitalization and all-cause death. The association between changes in cardiovascular risk factors with change in NT-proBNP was further assessed.ResultsA total of 9776 individuals (mean [SD] age, 57.1 [5.7] years at visit 2; 5523 [56.5%] women) were included in the study. Compared with participants with NT-proBNP level less than 125 pg/mL at both visits, participants with NT-proBNP level of 125 pg/mL or higher at both visits had an increase in incident HF (adjusted hazard ratio [HR], 2.40 [95% CI, 2.00-2.88]) and mortality risk (HR, 1.68 [95% CI, 1.47-1.91). Participants with NT-proBNP levels of 125 pg/mL or higher at visit 2 and less than 125 pg/mL at visit 4 had similar risk for HF and death (HR, 1.01 [95% CI, 0.71-1.43]; HR, 0.79 [95% CI, 0.61-1.01]) compared with the group with NT-proBNP levels of less than 125 pg/mL at both visits. The percent change in NT-proBNP was positively associated with HF and death (HR, 1.06 [95% CI, 1.02-1.10]; HR, 1.05 [95% CI, 1.03-1.08] per 1-SD increase, respectively). Change in systolic blood pressure, low-density lipoprotein cholesterol, triglyceride level, body mass index, and estimated glomerular filtration rate were significantly associated with change in NT-proBNP.Conclusions and RelevanceIn this study, 6-year change in NT-proBNP reflected dynamic change in risk for HF events and death among community-dwelling adults without prevalent clinical HF. These results support the utility of serial NT-proBNP measurements to improve risk stratification of patients with pre-HF.

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“…In the present study, we assessed the association between CCA parameters and the serum NT-proBNP level by adjusting for confounding factors, including the age, sex (31), BMI (32), hemoglobin concentration (33), and indices of blood pressure (34). The sex-related differences in the serum NT-proBNP level are well known (31), and consistent with previous reports, we confirmed the significantly higher serum NT-proBNP level in women than in men in this study (data not shown).…”

Section: Discussionmentioning

confidence: 99%

Association of Common Carotid Artery Measurements with N-terminal Pro B-type Natriuretic Peptide in Elderly Participants

et al. 2020

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Objective Numerous studies have reported an association between common carotid artery (CCA) parameters and atherosclerotic cardiovascular disease (CVD). However, the association between CCA parameters and hemodynamic stress on the left ventricle in elderly patients remains unclear. Methods We assessed CCA parameters, including the height-adjusted CCA interadventitial diameter (diameter/height), mean intima-media thickness (IMT), number of plaques, plaque score, resistance index (RI), and pulsatility index (PI) with ultrasonography, using serum N-terminal pro-brain natriuretic peptide (NT-proBNP) levels as a marker for hemodynamic stress on the left ventricle in 1,315 participants ! 70 years old without CVD. Of these participants, 706 had hypertension, defined as taking antihypertensive medications, having a systolic blood pressure ! 140 mmHg, and/or having a diastolic blood pressure ! 90 mmHg. Results After adjusting for the confounding factors, the CCA interadventitial diameter/height was significantly associated with the log NT-proBNP in both the normotensive group (β=0.125, p=0.002) and hypertensive group (β=0.080, p=0.029). The RI was significantly associated with the log NT-proBNP in the hypertensive group (β=0.176, p<0.001) but not in the normotensive group. In addition, the PI was significantly associated with the log NT-proBNP in the hypertensive group (β=0.156, p<0.001) but not in the normotensive group. However, no significant association was observed between the mean IMT, number of plaques, and plaque score and log NT-proBNP. Conclusion CCA measurements may be useful markers for hemodynamic stress on the left ventricle in elderly patients.

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Association of N-Terminal Pro B-Type Natriuretic Peptide With Blood Pressure and Pulse Pressure in Elderly People　― A Cross-Sectional Population Study ―

Abstract: The results suggest that NT-proBNP concentrations may be a marker of not only ventricular dysfunction, but also arterial stiffness in the elderly population without CVD.

Cited by 8 publications

References 33 publications

Hypertension in older adults: Assessment, management, and challenges

Hypertension in older adults: Assessment, management, and challenges

Association of Long-term Change in N-Terminal Pro–B-Type Natriuretic Peptide With Incident Heart Failure and Death

Association of Common Carotid Artery Measurements with N-terminal Pro B-type Natriuretic Peptide in Elderly Participants

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Association of N-Terminal Pro B-Type Natriuretic Peptide With Blood Pressure and Pulse Pressure in Elderly People ― A Cross-Sectional Population Study ―

Abstract: The results suggest that NT-proBNP concentrations may be a marker of not only ventricular dysfunction, but also arterial stiffness in the elderly population without CVD.

Cited by 8 publications

References 33 publications

Hypertension in older adults: Assessment, management, and challenges

Hypertension in older adults: Assessment, management, and challenges

Association of Long-term Change in N-Terminal Pro–B-Type Natriuretic Peptide With Incident Heart Failure and Death

Association of Common Carotid Artery Measurements with N-terminal Pro B-type Natriuretic Peptide in Elderly Participants

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Product

Resources

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Association of N-Terminal Pro B-Type Natriuretic Peptide With Blood Pressure and Pulse Pressure in Elderly People　― A Cross-Sectional Population Study ―