Long-term pattern of brain natriuretic peptide and N-terminal pro brain natriuretic peptide and its determinants in the general population: contribution of age, gender, and cardiac and extra-cardiac factors

• Published in: European journal of heart failure Vol. 15; no. 8; pp. 859 - 867
• Main Authors: Luchner, Andreas, Behrens, Gundula, Stritzke, Jan, Markus, Marcello, Stark, Klaus, Peters, Annette, Meisinger, Christa, Leitzmann, Michael, Hense, Hans-Werner, Schunkert, Heribert, Heid, Iris M.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.08.2013
• Subjects: 10-year-follow-up; Adrenergic beta-Antagonists - therapeutic use; Adult; Aged; Aging - blood; Biomarkers - blood; Body Mass Index; Cohort Studies; Diabetes Mellitus - blood; Diabetes Mellitus - epidemiology; Echocardiography; Female; Germany - epidemiology; Heart Atria - diagnostic imaging; Heart failure; Heart Ventricles - diagnostic imaging; Humans; Hypertension; Hypertrophy, Left Ventricular - blood; Hypertrophy, Left Ventricular - epidemiology; Longitudinal Studies; LV hypertrophy; Male; Middle Aged; Multivariate Analysis; Myocardial Infarction - blood; Myocardial Infarction - epidemiology; Natriuretic Peptide, Brain - blood; Natriuretic peptides; Organ Size; Peptide Fragments - blood; Regression Analysis; Sex Factors; Heart failure; Hypertension; Echocardiography; LV hypertrophy; 10-year-follow-up; Natriuretic peptides
• ISSN: 1388-9842; 1879-0844; 1879-0844
• DOI: 10.1093/eurjhf/hft048

Aims The natriuretic peptides BNP and NT‐proBNP are potent cardiac markers, but knowledge of long‐term changes is sparse. We thus quantified determinants of change in BNP and NT‐proBNP in a study of south German residents (KORA). Methods and results A total of 1005 men and women (age 25–74 years, mean 48 years) underwent physical examination and echocardiography at baseline and at follow‐up after 10 years. The current analysis comprised 877 subjects with dual measurements of BNP and NT‐proBNP. Both markers increased in both sexes (P < 0.001) during the 10‐year follow‐up, and higher levels in women persisted across time (P for sex difference <0.001). Among baseline covariates, predictors for 10‐year change of NT‐proBNP, BNP, or both were age, sex, diabetes status, and heart rate (multivariable regression analysis, each P < 0.05). However, changes of covariates over the 10‐year follow‐up were much stronger determinants. Specifically, incident myocardial infarction, new beta‐blocker medication, and increased cardiac parameters (left atrial diameter, LV end‐diastolic diameter, and LV mass index) were associated with increasing BNP, NT‐proBNP, or both, whereas increased heart rate, haematocrit, and body mass index (BMI) were associated with decreasing BNP and NT‐proBNP (all P < 0.05). Conclusion Next to ageing and sex, a variety of changes in covariates reflecting the sequelae of cardiac remodelling as well as myocardial infarction and diabetes influence long‐term changes of BNP and NT‐proBNP. Of note, diabetes and increased BMI exert opposite effects. For interpretation of individual marker concentrations, a host of covariates needs to be considered, especially in subjects without prevalent or incident cardiac disease.