What factors are associated with high plasma B-type natriuretic peptide levels in a general Japanese population?

Kanda, Hideyuki; Kita, Yoshikuni; Okamura, Tomonori; Kadowaki, Takashi; Yoshida, Yuki; Nakamura, Yasuyuki; Ueshima, Hirotsugu

doi:10.1038/sj.jhh.1001792

Cited by 45 publications

(49 citation statements)

References 40 publications

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“…Apart from GFR, the observed associations of NP levels with ␤-blocker treatment (29 -32), LVM/BSA (33,34), and hemoglobin concentration (35,36) have previously been highlighted in isolation. Similar to previous studies (34), LVM/BSA better predicted NP levels than any echocardiographic variable assessed and, in particular, was superior to both blood and tissue Doppler indices of diastolic dysfunction.…”

Section: Discussionmentioning

confidence: 99%

Natriuretic Peptides in Chronic Kidney Disease

Tagore

Ling

Yang

et al. 2008

Clinical Journal of the American Society of Nephrology

100

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Background and objectives: B-type natriuretic peptide (BNP) and amino-terminal pro-B-type natriuretic peptide (NTproBNP) are biomarkers of cardiovascular disease that is common in patients with chronic kidney disease (CKD). Conflicting data on the influence of glomerular filtration rate (GFR) on BNP and NT-proBNP levels in CKD may stem from failure to account fully for the effects of coexistent cardiac disease, dysfunction, and volume overload.Design, setting, participants, & measurements: Prospective head-to-head comparison of plasma BNP and NT-proBNP in ambulatory euvolemic CKD patients with normal LV ejection fraction and no manifest cardiac or vascular disease. GFR was estimated by the Modification of Diet in Renal Disease formula, BNP and NT-proBNP measured using Abbott AxSYM and Roche Elecsys assays, respectively, and cardiac morphology and function assessed by transthoracic echocardiography.Results: In 142 patients (42% female) of mean age 60 ؎ 11 yr, mean left ventricular ejection fraction was 71% ؎ 6%, GFR 38 ؎ 14 ml/min per 1.73 m 2 , and median BNP and NT-proBNP level 59 and 311 pg/ml, respectively. Multivariate predictors of NT-proBNP level were GFR, ␤-blocker usage, LV mass index, and hemoglobin level. Plasma BNP was independently predicted by LV mass index and ␤-blocker usage but not GFR. In the 74 patients without diastolic dysfunction, there was a significant rise in NT-proBNP but not BNP as GFR declined.Conclusions: Unlike NT-proBNP, plasma BNP level is relatively independent of GFR. BNP may therefore be the more appropriate biomarker to screen for cardiac dysfunction in CKD.

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Section: Discussionmentioning

confidence: 99%

Natriuretic Peptides in Chronic Kidney Disease

Tagore

Ling

Yang

et al. 2008

Clinical Journal of the American Society of Nephrology

100

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“…Wang et al 9 demonstrated recently an inverse relationship between serum BNP and body mass index that could be a potential link between obesity and hypertension if obese patients have lower BNP levels at given levels of wall stress. However, others have not found this association, 10 and it has been suggested recently that the inverse relationship between BNP and body mass index may only reflect an increase in BNP and a decrease in body mass index with aging. 11 No studies of the effect of obesity or other elements of the metabolic syndrome on Nt-proBNP are available.…”

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confidence: 98%

N-Terminal Pro Brain Natriuretic Peptide Is Inversely Related to Metabolic Cardiovascular Risk Factors and the Metabolic Syndrome

et al. 2005

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Abstract-We wanted to investigate the relationship of N-terminal pro brain natriuretic peptide (Nt-proBNP) The metabolic syndrome was associated with lower Nt-proBNP (35 pg/mL versus 48 pg/mL; PϽ0.001) and shifted the positive relationship between pulse pressure and Nt-proBNP to the right (ie, higher blood pressure for a given level of Nt-proBNP). The metabolic syndrome was associated with lower Nt-proBNP levels and shifted the positive relationship between Nt-proBNP and pulse pressure to the right, creating a possible link between the metabolic syndrome and hypertension. Key Words: risk factors Ⅲ albuminuria Ⅲ hypertrophy Ⅲ natriuretic peptides Ⅲ obesity B rain natriuretic peptide (BNP) is synthesized in myocardial cells as a response to increased wall stress 1 in relation to heart failure 2 or acute myocardial ischemia 3 as a prohormone that is cleaved into BNP and N-terminal proBNP (Nt-proBNP). High BNP as well as high NtproBNP are new promising cardiovascular (CV) risk markers 4 and have been associated with high blood pressure (BP), 5 left ventricular (LV) hypertrophy, 6 and albuminuria. 7,8 Because Nt-proBNP as well as BP, LV mass, and albuminuria increase with aging, it is unclear whether these associations merely rely on aging. Wang et al 9 demonstrated recently an inverse relationship between serum BNP and body mass index that could be a potential link between obesity and hypertension if obese patients have lower BNP levels at given levels of wall stress. However, others have not found this association, 10 and it has been suggested recently that the inverse relationship between BNP and body mass index may only reflect an increase in BNP and a decrease in body mass index with aging. 11 No studies of the effect of obesity or other elements of the metabolic syndrome on Nt-proBNP are available.Therefore, the aim of the present study was to evaluate the association of Nt-proBNP to metabolic and hemodynamic CV risk factors, including the metabolic syndrome, 24-hour ambulatory BP, LV hypertrophy, pulse wave velocity (PWV), and urine albumin/creatinine ratio (UACR) in 4 different age groups to control for age.

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“…This finding was consistent with a previous report. 14 Measurement of BNP may be useful for the evaluation of patients because it is a simple procedure and an objective biochemical marker. More accurate assessment could be done using measurement of BNP in combination with other biomarkers, such as troponin T or C-reactive protein.…”

Section: Bnp and Other Factorsmentioning

confidence: 99%

“…5 It has been reported that BNP is also increased in hypertensive patients without heart failure and in community residents with hypertension. [11][12][13][14] Hypertensive patients with cardiac hypertrophy have higher plasma BNP concentrations and the patients with increased BNP suffer from a higher incidence of cardiac events. 11,12 Recently, diastolic failure has attracted more attention in relation to hypertensive heart disease and this is associated with an increase in BNP.…”

mentioning

confidence: 99%

Clinical Significance of B-Type Natriuretic Peptide in the Assessment of Untreated Hypertension

Seki

Tsurusaki

Kasai

et al. 2008

Circ J

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ypertension is widely recognized as a major risk factor for cardiovascular disease. 1,2 When initiating antihypertensive treatment, it is important to assess clinical characteristics and the severity of organ damage. [3][4][5] The plasma level of B-type natriuretic peptide (BNP) is well established as a useful marker of cardiac dysfunction, prognosis and response to treatment in patients with heart failure. [6][7][8][9] In patients with heart failure, secretion of BNP increases in proportion to the severity of left ventricular (LV) dysfunction, as indicated by the pulmonary capillary wedge pressure and LV end-diastolic pressure or the New York Heart Association class. 6,10 However, the measurement of BNP for clinical guidelines in hypertension is not recommended at present. 5 It has been reported that BNP is also increased in hypertensive patients without heart failure and in community residents with hypertension. 11-14 Hypertensive patients with cardiac hypertrophy have higher plasma BNP concentrations and the patients with increased BNP suffer from a higher incidence of cardiac events. 11,12 Recently, diastolic failure has attracted more attention in relation to hypertensive heart disease and this is associated with an increase in BNP. 15,16 Early and accurate diagnosis of diastolic failure is important to improve the prognosis of patients with heart failure. However, the role of BNP in the clinical assessment of hypertension has not been fully investigated and the actual meaning of a slight increase in BNP is still unclear. [11][12][13] The Framingham study demonstrated that an increase in BNP predicted the risk of death and cardiovascular events in community residents. 17 Neurohumoral factors become activated and play important roles in the pathophysiology of chronic heart disease. It would be helpful in general practice if BNP could be used as a marker of the risk of cardiovascular events in hypertensive patients.In the present study, we examined the relationship between plasma BNP levels and various clinical parameters to assess the usefulness of BNP as a marker for the severity of hypertension or organ damage in untreated hypertensives. The patients were clinically graded by BNP level. MethodsThe present study group comprised 154 persons with essential hypertension who attended our outpatient clinic (84 Circ J 2008; 72: 770 -777 (Received July 30, 2007; revised manuscript received October 22, 2007; accepted December 19, 2007 Methods and ResultsThe relationship between the plasma BNP level and various clinical parameters was examined in 154 untreated hypertensive patients without heart failure or atrial fibrillation (mean age: 58.0±10.7; mean blood pressure: 164.5±15.2/99.1±9.7 mmHg; mean BNP: 32.7±36.7 pg/ml). First, the patients were divided into 2 groups based on BNP: normal (<18.5 pg/ml, mean 9.7±5.7, n=69); or elevated (>18.5 pg/ml, mean 51.4± 40.4, n=85). The elevated BNP group had a significantly greater electrocardiographic voltage index (SV1+RV5; 3.7±1.2 vs 3.2±0.8 mV, p=0.0029), cardiothora...

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What factors are associated with high plasma B-type natriuretic peptide levels in a general Japanese population?

Cited by 45 publications

References 40 publications

Natriuretic Peptides in Chronic Kidney Disease

Natriuretic Peptides in Chronic Kidney Disease

N-Terminal Pro Brain Natriuretic Peptide Is Inversely Related to Metabolic Cardiovascular Risk Factors and the Metabolic Syndrome

Clinical Significance of B-Type Natriuretic Peptide in the Assessment of Untreated Hypertension

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