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Variability of NT-proBNP and its relationship with inflammatory status in patients with stable essential hypertension: a 2-year follow-up study.

Roselló-Lletí E, Calabuig JR, Morillas P, Cortés R, Martínez-Dolz L, Almenar L, González-Juanatey JR, Lauwers C, Salvador A, Portolés M, Bertomeu V, Rivera M - PLoS ONE (2012)

Bottom Line: No differences in NT-proBNP were found with respect to the basal stage in the hypertrophic group, but significant changes were found in non-hypertrophic subjects.Measured variations in peptide levels, exceeding 35% in a 12-month follow-up and 41% in a 24-month follow-up, may indicate an increase in cardiovascular risk, and therefore implies adjustment in the medical treatment.In addition, this study shows a link between neurohormonal and inflammatory activation in these patients.

View Article: PubMed Central - PubMed

Affiliation: Cardiocirculatory Unit, Research Center, Hospital Universitario La Fe, Valencia, Spain. rivera_jmi@gva.es

ABSTRACT

Background: The variability of NT-proBNP levels has been studied in heart failure, yet no data exist on these changes over time in hypertensive patients. Furthermore, studies on the relationship between natriuretic peptides and inflammatory status are limited.

Methodology/principal findings: 220 clinically and functionally asymptomatic stable patients (age 59 ± 13, 120 male) out of 252 patients with essential hypertension were followed up, and NT-proBNP was measured at baseline, 12 and 24 months. No differences in NT-proBNP were found with respect to the basal stage in the hypertrophic group, but significant changes were found in non-hypertrophic subjects. The reproducibility of NT-proBNP measurements was better in patients with hypertrophy than in the non-hypertrophic group for the three intervals (stage I-basal; stage II-stage I; stage II-basal) with a reference change value of 34%, 35% and 41%, respectively, in the hypertrophic group. A more elevated coefficient of correlation was obtained in the hypertrophic group than in patients without hypertrophy: basal versus stage I (r = 0.79, p < 0.0001 and r = 0.59, p < 0.0001) and stage I versus stage II (r = 0.86, p < 0.0001 and r = 0.56, p < 0.0001). Finally, levels of NT-proBNP significantly correlated with sTNF-R1 (p < 0.0001) and IL-6 (p < 0.01) during follow-up. A multivariate linear regression analysis showed that sTNF-R1 is an independent factor of NT-proBNP.

Conclusions/significance: This work shows that there is good stability in NT-proBNP levels in a follow-up study of asymptomatic patients with stable hypertension and left ventricular hypertrophy. As a consequence, assessment of NT-proBNP concentrations may be a useful tool for monitoring the follow-up of hypertensive patients with hypertrophy. Measured variations in peptide levels, exceeding 35% in a 12-month follow-up and 41% in a 24-month follow-up, may indicate an increase in cardiovascular risk, and therefore implies adjustment in the medical treatment. In addition, this study shows a link between neurohormonal and inflammatory activation in these patients.

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Related in: MedlinePlus

Serum logarithm of NT-proBNP levels during a 24-month follow-up.Measurements represent the median value at basal (1), stage I (2) and stage II (3). NT-proBNP, N-terminal pro-brain natriuretic peptide levels; stage I, 12-month follow-up; stage II, 24-month follow-up. **p<0.01 with respect to basal levels.
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pone-0031189-g001: Serum logarithm of NT-proBNP levels during a 24-month follow-up.Measurements represent the median value at basal (1), stage I (2) and stage II (3). NT-proBNP, N-terminal pro-brain natriuretic peptide levels; stage I, 12-month follow-up; stage II, 24-month follow-up. **p<0.01 with respect to basal levels.

Mentions: The baseline characteristics and natriuretic peptide serum levels of the hypertensive patients in the three stages according to hypertrophy are shown in Tables 1 (LVH group, n = 122) and 2 (non-LVH group, n = 98). Significant differences in blood pressure and total cholesterol levels were observed with respect to the basal stage in both groups. Body mass index, heart rate, biochemical values, left ventricular mass index and diastolic function variables did not show any statistical changes. In addition, significant differences were found in ejection fraction and NT-proBNP concentration in the non-LVH group. Figure 1 shows the mean of NT-proBNP serum levels over the entire study according to left ventricular hypertrophy. No differences were found with respect to the basal stage in the LVH group, but significant changes were observed in non-LVH subjects. NT-proBNP levels were increased in LVH hypertensive patients compared to patients without hypertrophy (p<0.0001).


Variability of NT-proBNP and its relationship with inflammatory status in patients with stable essential hypertension: a 2-year follow-up study.

Roselló-Lletí E, Calabuig JR, Morillas P, Cortés R, Martínez-Dolz L, Almenar L, González-Juanatey JR, Lauwers C, Salvador A, Portolés M, Bertomeu V, Rivera M - PLoS ONE (2012)

Serum logarithm of NT-proBNP levels during a 24-month follow-up.Measurements represent the median value at basal (1), stage I (2) and stage II (3). NT-proBNP, N-terminal pro-brain natriuretic peptide levels; stage I, 12-month follow-up; stage II, 24-month follow-up. **p<0.01 with respect to basal levels.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3285617&req=5

pone-0031189-g001: Serum logarithm of NT-proBNP levels during a 24-month follow-up.Measurements represent the median value at basal (1), stage I (2) and stage II (3). NT-proBNP, N-terminal pro-brain natriuretic peptide levels; stage I, 12-month follow-up; stage II, 24-month follow-up. **p<0.01 with respect to basal levels.
Mentions: The baseline characteristics and natriuretic peptide serum levels of the hypertensive patients in the three stages according to hypertrophy are shown in Tables 1 (LVH group, n = 122) and 2 (non-LVH group, n = 98). Significant differences in blood pressure and total cholesterol levels were observed with respect to the basal stage in both groups. Body mass index, heart rate, biochemical values, left ventricular mass index and diastolic function variables did not show any statistical changes. In addition, significant differences were found in ejection fraction and NT-proBNP concentration in the non-LVH group. Figure 1 shows the mean of NT-proBNP serum levels over the entire study according to left ventricular hypertrophy. No differences were found with respect to the basal stage in the LVH group, but significant changes were observed in non-LVH subjects. NT-proBNP levels were increased in LVH hypertensive patients compared to patients without hypertrophy (p<0.0001).

Bottom Line: No differences in NT-proBNP were found with respect to the basal stage in the hypertrophic group, but significant changes were found in non-hypertrophic subjects.Measured variations in peptide levels, exceeding 35% in a 12-month follow-up and 41% in a 24-month follow-up, may indicate an increase in cardiovascular risk, and therefore implies adjustment in the medical treatment.In addition, this study shows a link between neurohormonal and inflammatory activation in these patients.

View Article: PubMed Central - PubMed

Affiliation: Cardiocirculatory Unit, Research Center, Hospital Universitario La Fe, Valencia, Spain. rivera_jmi@gva.es

ABSTRACT

Background: The variability of NT-proBNP levels has been studied in heart failure, yet no data exist on these changes over time in hypertensive patients. Furthermore, studies on the relationship between natriuretic peptides and inflammatory status are limited.

Methodology/principal findings: 220 clinically and functionally asymptomatic stable patients (age 59 ± 13, 120 male) out of 252 patients with essential hypertension were followed up, and NT-proBNP was measured at baseline, 12 and 24 months. No differences in NT-proBNP were found with respect to the basal stage in the hypertrophic group, but significant changes were found in non-hypertrophic subjects. The reproducibility of NT-proBNP measurements was better in patients with hypertrophy than in the non-hypertrophic group for the three intervals (stage I-basal; stage II-stage I; stage II-basal) with a reference change value of 34%, 35% and 41%, respectively, in the hypertrophic group. A more elevated coefficient of correlation was obtained in the hypertrophic group than in patients without hypertrophy: basal versus stage I (r = 0.79, p < 0.0001 and r = 0.59, p < 0.0001) and stage I versus stage II (r = 0.86, p < 0.0001 and r = 0.56, p < 0.0001). Finally, levels of NT-proBNP significantly correlated with sTNF-R1 (p < 0.0001) and IL-6 (p < 0.01) during follow-up. A multivariate linear regression analysis showed that sTNF-R1 is an independent factor of NT-proBNP.

Conclusions/significance: This work shows that there is good stability in NT-proBNP levels in a follow-up study of asymptomatic patients with stable hypertension and left ventricular hypertrophy. As a consequence, assessment of NT-proBNP concentrations may be a useful tool for monitoring the follow-up of hypertensive patients with hypertrophy. Measured variations in peptide levels, exceeding 35% in a 12-month follow-up and 41% in a 24-month follow-up, may indicate an increase in cardiovascular risk, and therefore implies adjustment in the medical treatment. In addition, this study shows a link between neurohormonal and inflammatory activation in these patients.

Show MeSH
Related in: MedlinePlus