Abstract
BACKGROUND - Higher levels of N-terminal prohormone brain-type natriuretic peptide (NT-proBNP) predict cardiovascular disease (CVD) in several disease states, but few data are available in patients with chronic kidney disease or in blacks. METHODS AND RESULTS - The African American Study of Kidney Disease and Hypertension trial enrolled hypertensive blacks with a glomerular filtration rate of 20 to 65 mL • min • 1.73 m and no other identified cause of kidney disease. NT-proBNP was measured with a sandwich chemiluminescence immunoassay (coefficient of variation 2.9%) in 994 African American Study of Kidney Disease and Hypertension participants. NT-proBNP was categorized as undetectable, low, moderate, or high. Proteinuria was defined as 24-hour urinary protein-creatinine ratio >0.22. A total of 134 first CVD events (CVD death or hospitalization for coronary artery disease, heart failure, or stroke) occurred over a median of 4.3 years. Participants with high NT-proBNP were much more likely to have a CVD event than participants with undetectable NT-proBNP after adjustment (relative hazard 4.0 [95% confidence interval [CI] 2.1 to 7.6]). A doubling of NT-proBNP was associated with a relative hazard of 1.3 (95% CI 1.0 to 1.6) for coronary artery disease, 1.7 (95% CI 1.4 to 2.2) for heart failure, 1.1 (95% CI 0.9 to 1.4) for stroke, and 1.8 (95% CI 1.4 to 2.4) for CVD death. The association of NT-proBNP with CVD events was significantly stronger (Pinteraction=0.05) in participants with than in those without proteinuria. Higher NT-proBNP was not associated with renal disease progression. CONCLUSIONS - These results suggest that elevated NT-proBNP levels are associated with higher CVD risk among blacks with hypertensive kidney disease. This association may be stronger in individuals with significant proteinuria.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 1685-1692 |
| Number of pages | 8 |
| Journal | Circulation |
| Volume | 117 |
| Issue number | 13 |
| DOIs | |
| State | Published - Apr 2008 |
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Keywords
- Cardiovascular diseases
- Heart failure
- Hypertension, renal
- Kidney
- Natriuretic peptides
ASJC Scopus subject areas
- Physiology
- Cardiology and Cardiovascular Medicine
Cite this
N-terminal prohormone brain natriuretic peptide as a predictor of cardiovascular disease and mortality in blacks with hypertensive kidney disease : The African American Study of Kidney Disease and Hypertension (AASK). / Astor, B. C.; Yi, S.; Hiremath, L.; Corbin, T.; Pogue, V.; Wilkening, B.; Peterson, G.; Lewis, J.; Lash, J. P.; Van Lente, F.; Gassman, J.; Wang, X.; Bakris, G.; Appel, L. J.; Contreras, G.
In: Circulation, Vol. 117, No. 13, 04.2008, p. 1685-1692.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - N-terminal prohormone brain natriuretic peptide as a predictor of cardiovascular disease and mortality in blacks with hypertensive kidney disease
T2 - The African American Study of Kidney Disease and Hypertension (AASK)
AU - Astor, B. C.
AU - Yi, S.
AU - Hiremath, L.
AU - Corbin, T.
AU - Pogue, V.
AU - Wilkening, B.
AU - Peterson, G.
AU - Lewis, J.
AU - Lash, J. P.
AU - Van Lente, F.
AU - Gassman, J.
AU - Wang, X.
AU - Bakris, G.
AU - Appel, L. J.
AU - Contreras, G.
PY - 2008/4
Y1 - 2008/4
N2 - BACKGROUND - Higher levels of N-terminal prohormone brain-type natriuretic peptide (NT-proBNP) predict cardiovascular disease (CVD) in several disease states, but few data are available in patients with chronic kidney disease or in blacks. METHODS AND RESULTS - The African American Study of Kidney Disease and Hypertension trial enrolled hypertensive blacks with a glomerular filtration rate of 20 to 65 mL • min • 1.73 m and no other identified cause of kidney disease. NT-proBNP was measured with a sandwich chemiluminescence immunoassay (coefficient of variation 2.9%) in 994 African American Study of Kidney Disease and Hypertension participants. NT-proBNP was categorized as undetectable, low, moderate, or high. Proteinuria was defined as 24-hour urinary protein-creatinine ratio >0.22. A total of 134 first CVD events (CVD death or hospitalization for coronary artery disease, heart failure, or stroke) occurred over a median of 4.3 years. Participants with high NT-proBNP were much more likely to have a CVD event than participants with undetectable NT-proBNP after adjustment (relative hazard 4.0 [95% confidence interval [CI] 2.1 to 7.6]). A doubling of NT-proBNP was associated with a relative hazard of 1.3 (95% CI 1.0 to 1.6) for coronary artery disease, 1.7 (95% CI 1.4 to 2.2) for heart failure, 1.1 (95% CI 0.9 to 1.4) for stroke, and 1.8 (95% CI 1.4 to 2.4) for CVD death. The association of NT-proBNP with CVD events was significantly stronger (Pinteraction=0.05) in participants with than in those without proteinuria. Higher NT-proBNP was not associated with renal disease progression. CONCLUSIONS - These results suggest that elevated NT-proBNP levels are associated with higher CVD risk among blacks with hypertensive kidney disease. This association may be stronger in individuals with significant proteinuria.
AB - BACKGROUND - Higher levels of N-terminal prohormone brain-type natriuretic peptide (NT-proBNP) predict cardiovascular disease (CVD) in several disease states, but few data are available in patients with chronic kidney disease or in blacks. METHODS AND RESULTS - The African American Study of Kidney Disease and Hypertension trial enrolled hypertensive blacks with a glomerular filtration rate of 20 to 65 mL • min • 1.73 m and no other identified cause of kidney disease. NT-proBNP was measured with a sandwich chemiluminescence immunoassay (coefficient of variation 2.9%) in 994 African American Study of Kidney Disease and Hypertension participants. NT-proBNP was categorized as undetectable, low, moderate, or high. Proteinuria was defined as 24-hour urinary protein-creatinine ratio >0.22. A total of 134 first CVD events (CVD death or hospitalization for coronary artery disease, heart failure, or stroke) occurred over a median of 4.3 years. Participants with high NT-proBNP were much more likely to have a CVD event than participants with undetectable NT-proBNP after adjustment (relative hazard 4.0 [95% confidence interval [CI] 2.1 to 7.6]). A doubling of NT-proBNP was associated with a relative hazard of 1.3 (95% CI 1.0 to 1.6) for coronary artery disease, 1.7 (95% CI 1.4 to 2.2) for heart failure, 1.1 (95% CI 0.9 to 1.4) for stroke, and 1.8 (95% CI 1.4 to 2.4) for CVD death. The association of NT-proBNP with CVD events was significantly stronger (Pinteraction=0.05) in participants with than in those without proteinuria. Higher NT-proBNP was not associated with renal disease progression. CONCLUSIONS - These results suggest that elevated NT-proBNP levels are associated with higher CVD risk among blacks with hypertensive kidney disease. This association may be stronger in individuals with significant proteinuria.
KW - Cardiovascular diseases
KW - Heart failure
KW - Hypertension, renal
KW - Kidney
KW - Natriuretic peptides
UR - http://www.scopus.com/inward/record.url?scp=41649097136&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=41649097136&partnerID=8YFLogxK
U2 - 10.1161/CIRCULATIONAHA.107.724187
DO - 10.1161/CIRCULATIONAHA.107.724187
M3 - Article
C2 - 18362234
AN - SCOPUS:41649097136
VL - 117
SP - 1685
EP - 1692
JO - Circulation
JF - Circulation
SN - 0009-7322
IS - 13
ER -