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Race-based demographic, anthropometric and clinical correlates of N-terminal-pro B-type natriuretic peptide

  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Nirav Patel
    Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Division of Cardiovascular Disease, University of Alabama at Birmingham, 1900 University Blvd., Birmingham, AL, USA
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  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Orlando M. Gutiérrez
    Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Division of Nephrology, Department of Medicine, University of Alabama at Birmingham, 1900 University Blvd., Birmingham, AL, USA

    Department of Epidemiology, University of Alabama at Birmingham, 1655 University Blvd., Birmingham, AL, USA
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  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Garima Arora
    Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Division of Cardiovascular Disease, University of Alabama at Birmingham, 1900 University Blvd., Birmingham, AL, USA
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  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    George Howard
    Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Department of Biostatistics, University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL, USA
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  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Virginia J. Howard
    Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Department of Epidemiology, University of Alabama at Birmingham, 1655 University Blvd., Birmingham, AL, USA
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  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Suzanne E. Judd
    Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Department of Biostatistics, University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL, USA
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  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Sumanth D. Prabhu
    Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Division of Cardiovascular Disease, University of Alabama at Birmingham, 1900 University Blvd., Birmingham, AL, USA

    Section of Cardiology, Birmingham Veterans Affairs Medical Center, 700 19th Street S., Birmingham, AL, USA
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  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Emily B. Levitan
    Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Department of Epidemiology, University of Alabama at Birmingham, 1655 University Blvd., Birmingham, AL, USA
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  • Mary Cushman
    Affiliations
    Division of Cardiovascular Disease, University of Alabama at Birmingham, 1900 University Blvd., Birmingham, AL, USA

    Department of Medicine, Larner College of Medicine at the University of Vermont, E-126 Given Building, 89 Beaumont Ave, Burlington, VT, USA
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  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Pankaj Arora
    Correspondence
    Corresponding author at: Division of Cardiovascular Disease, 1670 University Blvd., Volker Hall B140, University of Alabama at Birmingham, Birmingham, AL 35294-0019, USA.
    Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Division of Cardiovascular Disease, University of Alabama at Birmingham, 1900 University Blvd., Birmingham, AL, USA

    Section of Cardiology, Birmingham Veterans Affairs Medical Center, 700 19th Street S., Birmingham, AL, USA
    Search for articles by this author
  • Author Footnotes
    1 This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
Published:February 20, 2019DOI:https://doi.org/10.1016/j.ijcard.2019.02.034
Race-based demographic, anthropometric and clinical correlates of N-terminal-pro B-type natriuretic peptide
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      Highlights

      • •
        Population studies have shown that black race is a natriuretic peptide (NP) deficiency state.
      • •
        The effect of age, sex, body mass index (BMI) and estimated glomerular filtration rate (eGFR) on NP levels by race have not been described.
      • •
        The relationship of N-terminal-pro-B-type NP (NT-proBNP) with age and sex was similar in both races.
      • •
        The inverse relationship between NT-proBNP and BMI was linear among whites, while non-linear among blacks.
      • •
        The non-linear inverse relationship of NT-proBNP with eGFR significantly differed by race.

      Abstract

      Background

      Population studies have shown that black race is a natriuretic peptide (NP) deficiency state. We sought to assess whether the effects of age, sex, body mass index (BMI) and estimated glomerular filtration rate (eGFR) on N-terminal-pro-B-type NP (NT-proBNP) levels differ in white and black individuals.

      Methods

      The study population consisted of a stratified random cohort from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. The study outcomes were the effects of age, sex, BMI and eGFR on NT-proBNP levels independent of socioeconomic and cardiovascular disease factors. Multivariable regression analyses were used to assess the effects of age, sex, BMI and eGFR on NT-proBNP levels in blacks and whites.

      Results

      Of the 27,679 participants in the weighted sample, 54.7% were females, 40.6% were black, and the median age was 64 years. Every 10-year higher age was associated with 38% [95% confidence interval (CI): 30%–45%] and 34% (95% CI: 22%–43%) higher NT-proBNP levels in whites and blacks, respectively. Female sex was associated with 31% (95% CI: 20%–43%) higher NT-proBNP levels in whites and 28% (95% CI: 15%–45%) higher in blacks. There was a significant linear inverse relationship between BMI and NT-proBNP in whites and a non-linear inverse relationship in blacks. Whites and blacks had a non-linear inverse relationship between eGFR and NT-proBNP. However, the non-linear relationship between NT-proBNP and eGFR differed by race (p = 0.01 for interaction).

      Conclusions

      The association of age and sex with NT-proBNP levels was similar in blacks and whites but the form of the BMI and eGFR relationship differed by race.

      Keywords

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      Article info

      Publication history

      Published online: February 20, 2019
      Accepted: February 18, 2019
      Received in revised form: February 1, 2019
      Received: November 18, 2018

      Identification

      DOI: https://doi.org/10.1016/j.ijcard.2019.02.034

      Copyright

      © 2019 Elsevier B.V. All rights reserved.

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      Linked Article

      • Race/ethnicity and plasma NT-proBNP in black and white individuals: How it matters
        International Journal of CardiologyVol. 286
        • Preview
          Population studies from the United States have established that African ancestry is accompanied by a higher cardiovascular risk, translating in a higher incidence of heart failure (HF) and greater 5-year mortality [1]. This may be, in part, due to more prevalent clinical risk factors for HF/death among Blacks, such as higher rates of hypertension, diabetes mellitus, and obesity and also more frequent genetic predisposition toward earlier and more severe cardiovascular disease.
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