Published Online
on August 29, 2005

A more recent version of this article appeared on October 1, 2005

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Submitted on April 22, 2005
Revised on May 9, 2005

N-Terminal Pro Brain Natriuretic Peptide Is Inversely Related to Metabolic Cardiovascular Risk Factors and the Metabolic Syndrome

Michael H. Olsen^*; Tine W. Hansen; Marina K. Christensen; Finn Gustafsson; Susanne Rasmussen; Kristian Wachtell; Knut Borch-Johnsen; Hans Ibsen; Torben Jørgensen; and Per Hildebrandt

From the Research Center for Prevention and Health (M.H.O., T.W.H., S.R., T.J.), Glostrup University Hospital; Department of Cardiology (M.H.O., K.W.), Rigshospitalet; Department of Clinical Physiology and Nuclear Medicine (M.K.C.), Glostrup University Hospital; Department of Cardiology (F.G., P.H.), Frederiksberg University Hospital; Steno Diabetes Center (K.B.-J.), Gentofte; and Department of Internal Medicine (H.I.), Glostrup University Hospital, Denmark.

^* To whom correspondence should be addressed. E-mail: mho{at}dadlnet.dk.

Abstract--We wanted to investigate the relationship of N-terminal pro brain natriuretic peptide (Nt-proBNP) to metabolic and hemodynamic cardiovascular (CV) risk factors in the general population. From a population-based sample of 2656 people 41, 51, 61, or 71 years of age, we selected 2070 patients without previous stroke or myocardial infarction who did not receive any CV, antidiabetic, or lipid-lowering treatment in 1993 to 1994. Traditional CV risk factors, 24-hour blood pressures, left ventricular (LV) mass, and ejection fraction by echocardiography, pulse wave velocity, urine albumin/creatinine ratio (UACR), and serum Nt-proBNP were measured in 1993 to 1994. The metabolic syndrome was defined in accordance with the definition of the European Group for the Study of Insulin Resistance (EGIR). Higher log(Nt-proBNP) was in multiple regression analysis related to female gender (=-0.37), older age (=0.32), higher clinic pulse pressure (=0.20), lower serum total cholesterol (=-0.15), lower LVEF (=-0.08, all P<0.001), lower log(serum insulin) (=-0.07), lower log(plasma glucose) (=-0.06, both P<0.01, lower log(serum triglyceride) (=-0.06), lower body mass index (=-0.05); lower heart rate (=-0.05), higher logUACR (=0.04, all P<0.05) and higher log(LV mass index) (=0.04, P=0.07), adjusted R²=0.35, P<0.001). The metabolic syndrome was associated with lower Nt-proBNP (35 pg/mL versus 48 pg/mL; P<0.001) and shifted the positive relationship between pulse pressure and Nt-proBNP to the right (ie, higher blood pressure for a given level of Nt-proBNP). The metabolic syndrome was associated with lower Nt-proBNP levels and shifted the positive relationship between Nt-proBNP and pulse pressure to the right, creating a possible link between the metabolic syndrome and hypertension.

Key words: risk factors • albuminuria • hypertrophy • natriuretic peptides • obesity

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