Arterial stiffness as determinant of increased amino terminal pro-B-type natriuretic peptide levels in individuals with and without cardiovascular disease--the Rotterdam Study

J Hypertens. 2010 Oct;28(10):2061-7. doi: 10.1097/HJH.0b013e32833c96bb.

Abstract

Objective: Large artery stiffening has adverse effects on cardiac structure and function and, therefore, may be associated with elevated circulating levels of amino-terminal pro-B-type natriuretic peptide (NT-proBNP).

Methods: In a large community-dwelling older population (n = 6211, mean age 69.2 years), serum NT-proBNP, brachial pulse pressure (PP) and carotid-femoral pulse wave velocity (cfPWV) were measured.

Results: In individuals without cardiovascular disease (CVD), median NT-proBNP was 6.7 pmol/l in men (n = 2073) and 10.1 pmol/l in women (n = 3085) (P < 0.001). In these individuals, indices of arterial stiffness correlated with NT-proBNP with beta-coefficients for brachial PP and cfPWV of 0.315 and 0.255 in men and 0.233 and 0.232 in women (all P < 0.001). After multivariable adjustment (age, weight, height, mean arterial pressure, heart rate, smoking, diabetes, estimated glomerular filtration rate, total and high-density lipoprotein-cholesterol and use of lipid-lowering and antihypertensive medication), these associations remained significant for brachial PP and cfPWV in men and for brachial PP in women. In multivariable-adjusted models, brachial PP explained 20.3% and cfPWV 10.7% of the variation of NT-proBNP in men and, respectively, 10.8 and 9.4% in women. In patients with prevalent CVD, indices of arterial stiffness and NT-proBNP were unrelated in multivariable-adjusted models.

Conclusion: Our findings show that arterial stiffness is independently associated with elevated NT-proBNP levels in individuals without prevalent CVD. The association between vascular stiffness and NT-proBNP is stronger in men than in women and absent in individuals with prevalent CVD.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Blood Flow Velocity / physiology
  • Blood Pressure / physiology
  • Brachial Artery / physiology*
  • Brachial Artery / physiopathology
  • Cardiovascular Diseases / physiopathology*
  • Carotid Arteries / physiology*
  • Carotid Arteries / physiopathology
  • Cohort Studies
  • Elasticity / physiology*
  • Female
  • Femoral Artery / parasitology
  • Femoral Artery / physiology*
  • Femoral Artery / physiopathology
  • Humans
  • Linear Models
  • Male
  • Middle Aged
  • Natriuretic Peptide, Brain / blood*
  • Netherlands
  • Peptide Fragments / blood*
  • Prospective Studies
  • Regional Blood Flow / physiology
  • Sex Characteristics

Substances

  • Biomarkers
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain