The aim of the present study was 1) to test the ability of N-terminal pro-brain natriuretic peptide (NT-proBNP) to detect cardiovascular remodeling denoted by either left ventricular hypertrophy (LVH) or arterial stiffness and 2) to test its reproducibility on two different conditions.Design and method:
The study included 169 hypertensive subjects, aged 47 ± 16 years, 51.5% of whom were men. 24-h ambulatory blood pressure was 141/88 mmHg. None of them had symptoms of heart failure, ejection fraction < 50%, and eGFR <30 mL/min. LVH was defined by transthoracic echocardiography as greater than 115 g/m2 in men and > 95 g/m2 in women; increased arterial stiffness was defined by a carotid-femoral pulse wave velocity greater than 10 m/s.Results:
Mean daytime NT-proBNP was slightly higher than nighttime NT-proBNP (64 [30–140] vs. 56 [27–126] pg/mL, p = 0.005) but the 2 assessments were highly correlated (r = 0.919, p < 0.001). Values of NT-proBNP increased significantly according to the number of target organ damages: daytime NT-proBNP 40 [22–74], 75 [37–155], 243 [144–358] pg/mL, for 0, 1 and 2 organ damages respectively, p < 0.001). The areas under the receiver-operating characteristic curves and optimal NT-proBNP were respectively: 1) for LVH, 0.673 and 166 pg/mL; 2) for arterial stiffness 0.817 and 294 pg/mL; 3) for both target organ damages 0.826 and 346 pg/mL (Figure).Conclusions:
This study demonstrates that NT-proBNP mirrors the cardiovascular consequences of hypertension, which precedes overt heart failure. Based on that and also on a good reproducibility, NT-proBNP is a promising tool for the management of hypertensive patients.