Differences in Natriuretic Peptide Levels by Race/Ethnicity (From the Multi-Ethnic Study of Atherosclerosis)

Gupta, Deepak K.; Daniels, Lori B.; Cheng, Susan; deFilippi, Christopher R.; Criqui, Michael H.; Maisel, Alan S.; Lima, João A.C.; Bahrami, Hossein; Greenland, Philip; Cushman, Mary; Tracy, Russell P.; Siscovick, David S.; Bertoni, Alain G.; Cannone, Valentina; Burnett, John C.; Carr, J. Jeffrey; Wang, Thomas J.

doi:10.1016/j.amjcard.2017.06.030

Cited by 52 publications

(43 citation statements)

References 30 publications

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“…Though a few studies suggest that African-Americans have lower natriuretic peptide levels compared with white individuals, data from multi-ethnic cohorts are limited. [14][15][16][17][18][19][20] Furthermore, whether baseline differences in natriuretic peptides by race/ethnicity persist over time or change in response to intervention aimed at improving cardio-metabolic health is not known.…”

Section: Introductionmentioning

confidence: 99%

Racial/ethnic differences in circulating natriuretic peptide levels: The Diabetes Prevention Program

Gupta

Walford

et al. 2020

PLoS ONE

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Natriuretic peptides are cardiac-derived hormones that enhance insulin sensitivity and reduce fat accumulation. Low natriuretic peptide levels are associated with increased risk of type 2 diabetes mellitus (DM2); a condition with variable prevalence across racial/ethnic groups. Few studies have examined whether circulating natriuretic peptide levels and their response to preventive interventions for DM2 differ by race/ethnicity. The Diabetes Prevention Program (DPP) is a clinical trial (July 31, 1996-July 31, 2001) that randomized participants to preventive interventions for DM2. Using stored serum samples, we examined Nterminus pro-B-type natriuretic peptide (NT-proBNP) levels in 3,220 individuals (56% white; 19% African-American; 15% Hispanic; 5% American-Indian; 5% Asian). The influence of race/ethnicity on NT-proBNP concentrations at baseline and after two years of treatment with placebo, lifestyle, or metformin was examined with multivariable-adjusted regression. At baseline, NT-proBNP differed significantly by race (P < .001), with the lowest values in African-American individuals. Hispanic individuals also had lower baseline NT-proBNP levels compared with whites (P< .001), while NT-proBNP levels were similar between white, American-Indian, and Asian individuals. At two years of follow-up, NT-proBNP levels decreased in African-Americans in each of the DPP study arms, whereas they were stable or increased in the other racial/ethnic groups. In the DPP, African-American individuals had lower circulating NT-proBNP levels compared with individuals in other racial/ethnic groups at baseline and after two years of preventive interventions. Further studies should examine the cardio-metabolic implications of lower natriuretic peptide levels in African-Americans. Trial Registration: ClinicalTrials.gov NCT00004992

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Section: Introductionmentioning

confidence: 99%

Racial/ethnic differences in circulating natriuretic peptide levels: The Diabetes Prevention Program

Gupta

Walford

et al. 2020

PLoS ONE

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“…These findings may be explained partially by the differences in the NT-proBNP levels between White and Black individuals (10)(11)(12)(13). Black individuals have lower NT-proBNP levels than White individuals (10)(11)(12)(13). We speculate that Black individuals, when exposed to increased wall stress, such as pressure and volume overload, may not able to mount an appropriate NP response as compared with White individuals.…”

Section: L I N I C a L M E D I C I N Ementioning

confidence: 88%

“…We observed that the association of higher NT-proB-NP levels with incident HF differed by race, i.e., greater magnitude in HRs among White than Black individuals, albeit the absolute difference in the HRs for incident HF by race was small. These findings may be explained partially by the differences in the NT-proBNP levels between White and Black individuals (10)(11)(12)(13). Black individuals have lower NT-proBNP levels than White individuals (10)(11)(12)(13).…”

Section: L I N I C a L M E D I C I N Ementioning

confidence: 98%

“…There are some limitations of our study. Prior studies have shown that NP levels have a genetic basis (11,13). Self-reported characterization of race was used instead of genetic ancestry information markers in this study.…”

Section: L I N I C a L M E D I C I N Ementioning

confidence: 99%

“…However, the information on racial differences in the relationship between N-terminal pro-B-type NP (NT-proBNP) levels and incident HF is small. Study of racial differences in magnitude of association of NP levels with incident HF is of particular relevance because we and others recently described that Black individuals have significantly lower NP levels as compared with White individuals (10)(11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

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Racial differences in the association of NT-proBNP with risk of incident heart failure in REGARDS

Patel¹,

Cushman²,

Gutiérrez³

et al. 2019

JCI Insight

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BACKGROUND. Black individuals have lower natriuretic peptide levels and greater risk of heart failure (HF) than White individuals. Higher N-terminal pro-B-type natriuretic peptide (NT-proBNP) is associated with increased risk of incident HF, but little information is available in Black individuals. We examined race-specific differences in (a) the association of NT-proBNP with incident HF and (b) the predictive ability of NT-proBNP for incident HF across BMI and estimated glomerular filtration rate (eGFR) categories. METHODS.In a prospective case-cohort study, baseline NT-proBNP was measured among 687 participants with incident HF and 2923 (weighted 20,075) non-case randomly selected participants. Multivariable Cox proportional hazard modeling was used to assess the objectives of our study. Global Wald χ 2 score estimated from multivariable Cox models was used to assess predictive ability of NT-proBNP across BMI and eGFR categories. RESULTS.In the multivariable model, a doubling of NT-proBNP concentration was associated with greater risk of incident HF among White individuals (HR: 1.73; 95% CI: 1.55-1.94) than Black individuals (HR: 1.51; 95% CI: 1.34-1.70), with P interaction by race of 0.024. Higher NT-proBNP was the strongest predictor of incident HF across all BMI and eGFR categories among White individuals. In contrast, among Black individuals with obesity (BMI ≥ 30 kg/m 2 ) or eGFR less than 60 mL/min/1.73 m 2 , the predictive ability of NT-proBNP for incident HF was attenuated.CONCLUSIONS. The magnitude of the association of higher NT-proBNP with incident HF risk was

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Natriuretic Peptide Deficiency—When There Is Too Little of a Good Thing

Wang

2018

JAMA Cardiol

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Differences in Natriuretic Peptide Levels by Race/Ethnicity (From the Multi-Ethnic Study of Atherosclerosis)

Cited by 52 publications

References 30 publications

Racial/ethnic differences in circulating natriuretic peptide levels: The Diabetes Prevention Program

Racial/ethnic differences in circulating natriuretic peptide levels: The Diabetes Prevention Program

Racial differences in the association of NT-proBNP with risk of incident heart failure in REGARDS

Natriuretic Peptide Deficiency—When There Is Too Little of a Good Thing

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