on March 3, 2003
Published online before print March 3, 2003, doi: 10.1161/01.HYP.0000061116.20490.8D
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Submitted on November 27, 2002
From the National Heart, Lung, and Blood Institute's Framingham Heart Study (M.H.F., M.G.L., D.L., E.J.B., T.J.W., E.P.L., P.W.F.W., R.S.V.), Framingham, Mass; The MetroWest Medical Center (M.H.F.), Framingham, Mass; the Divisions of Cardiology and Clinical Epidemiology, Beth Israel Deaconess Medical Center, Harvard Medical School (D.L.), Boston, Mass; the National Heart, Lung, and Blood Institute (D.L.), Bethesda, Md; and the Cardiology Section (E.J.B., R.S.V.), Endocrinology Section (P.W.F.W.), and Department of Preventive Medicine and Epidemiology (M.G.L., D.L., E.J.B., P.W.F.W., R.S.V.), Boston University School of Medicine, Boston, Mass. * To whom correspondence should be addressed. E-mail: vasan{at}fram.nhlbi.nih.gov.
Abstract--Increased brain natriuretic peptide (BNP) expression in the ventricles antedates elevated blood pressure (BP) in experimental studies. We hypothesized that higher plasma BNP levels in nonhypertensive individuals may be associated with a greater likelihood of future BP increase and/or hypertension. We evaluated the relations of plasma BNP to longitudinal BP tracking and incidence of hypertension in 1801 nonhypertensive Framingham Heart Study participants (mean age, 56 years; 57% women) by using gender-specific multivariable logistic regression. Progression of BP stage was defined as an increment of one or more BP categories, as classified by the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC VI). Hypertension was defined as a systolic BP
Revised on December 26, 2002
Plasma Brain Natriuretic Peptide Levels and Blood Pressure Tracking in the Framingham Heart Study
Michael H. Freitag;
140 or diastolic BP 90 mm Hg or use of antihypertensive medications. On follow-up 4 years from baseline, progression of BP category was observed in 36.2% of men and 33.1% of women; hypertension developed in 16.4% of men and 15.5% of women. In multivariable models adjusting for known risk factors, elevated plasma BNP level was associated with increased risk of BP progression in men (odds ratio of 1.15 for trend across categories, P=0.046) but not in women (P=0.82). There were no significant trends of increasing incidence of hypertension across BNP categories in men or women. In our community-based sample, higher plasma BNP levels were associated with increased risk of BP progression in men but not women. Additional investigations are warranted to confirm these findings and elucidate the basis for these gender-related differences.
Key words: natriuretic peptides • blood pressure • hypertension, essential • epidemiology • hemodynamics
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