Relation of plasma midregional proatrial natriuretic peptide to target organ damage in adults with systemic hypertension

Am J Cardiol. 2009 May 1;103(9):1255-60. doi: 10.1016/j.amjcard.2009.01.012. Epub 2009 Mar 18.

Abstract

We tested the hypothesis that, in adults with essential hypertension, plasma levels of midregional proatrial natriuretic peptide (MR-proANP) are associated with target organ damage. MR-proANP is a newly described stable fragment of N-terminal proatrial natriuretic peptide. Participants included 1,919 adults with hypertension identified from the community (1,037 African-Americans, 65 +/- 9 years of age, 72% women; 882 non-Hispanic whites, 61 +/- 9 years of age, 55% women). We measured MR-proANP by an immunoluminometric assay. Measurements of target organ damage included the ankle-brachial index (ABI), urinary albumin-creatinine ratio (UACR), and left ventricular (LV) mass (available only in African-Americans). Generalized estimating equations were used to assess whether plasma MR-proANP was associated with measurements of target organ damage, independent of potential confounding variables. In African-Americans, higher MR-proANP was significantly associated with lower ABI (p <0.0001), higher UACR (p <0.0001), and greater LV mass (indexed to height to the power of 2.7, p <0.0001). After adjustment for age, gender, body mass index, systolic blood pressure, estimated glomerular filtration rate, smoking history, diabetes mellitus, total and high-density lipoprotein cholesterols, medication (blood pressure lowering, statin, and aspirin) use, and previous myocardial infarction or stroke, higher MR-proANP levels remained significantly associated with lower ABI (p = 0.01), higher UACR (p = 0.0007), and greater LV mass index (p <0.0001). In non-Hispanic whites, higher MR-proANP levels were significantly associated with lower ABI (p = 0.002) and greater UACR (p = 0.001), but not after adjustment for the covariates listed earlier. In conclusion, plasma MR-proANP may be a marker of target organ damage in the setting of hypertension, especially in African-Americans.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Age Distribution
  • Aged
  • Albuminuria / diagnosis
  • Albuminuria / epidemiology
  • Ankle Brachial Index
  • Atrial Natriuretic Factor / blood*
  • Atrial Natriuretic Factor / metabolism
  • Biomarkers / blood
  • Black or African American / statistics & numerical data
  • Blood Pressure Determination
  • Cohort Studies
  • Comorbidity
  • Creatinine / urine
  • Female
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Hypertension / blood*
  • Hypertension / diagnosis
  • Hypertension / epidemiology*
  • Hypertrophy, Left Ventricular / diagnosis*
  • Hypertrophy, Left Ventricular / epidemiology*
  • Incidence
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Probability
  • Prognosis
  • Protein Precursors / blood*
  • Protein Precursors / metabolism
  • Risk Assessment
  • Severity of Illness Index
  • Sex Distribution
  • Survival Analysis
  • White People / statistics & numerical data

Substances

  • Biomarkers
  • N-terminal proatrial natriuretic peptide
  • Protein Precursors
  • Atrial Natriuretic Factor
  • Creatinine