| N-Terminal Pro-Brain Natriuretic Peptide: A Powerful Predictor of Mortality in Hypertension. | |
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MedLine Citation:
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PMID: 21383312 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Natriuretic peptides are controregulatory hormones associated with cardiac remodeling, namely, left ventricular hypertrophy and systolic/diastolic dysfunction. We intended to address the prognostic value of N-terminal pro-brain natriuretic peptide (NT-proBNP) in hypertension. We prospectively studied the relationship between plasma NT-proBNP and all-cause mortality in 684 hypertensive patients with no history or symptoms of heart failure referred for hypertension workup in our institution from 1998 to 2008. After a mean duration of 5.7 years, we observed 40 deaths (1.04 deaths per 100 patients per year). After adjustment for traditional cardiovascular risk factors, including ambulatory blood pressure and serum creatinine, the risk for all-cause mortality more than doubled with each increment of 1 log NT-proBNP (hazard ratio: 2.33 [95% CI: 1.36 to 3.96]). The risk of death of patients with plasma NT-proBNP ≥133 pg/mL (third tertile of the distribution) was 3.3 times that of patients with values <50.8 pg/mL (first tertile; hazard ratio: 3.30 [95% CI: 0.90 to 12.29]). This predictive value was independent of, and superior to, that of 2 ECG indexes of left ventricular hypertrophy, the Sokolov-Lyon index and the amplitude of the R wave in lead aVL. In addition, it persisted in patients without ECG left ventricular hypertrophy, which allowed refining risk stratification in this relatively low-risk patient category. In this large sample of hypertensive patients, plasma NT-proBNP appeared as a strong prognostic marker. This performance, together with the ease of measurement, low cost, and widespread availability of NT-proBNP test kits, should prompt a wide use of this marker for risk stratification in hypertension. |
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Authors:
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Vinciane Paget; Liliana Legedz; Nathalie Gaudebout; Nicolas Girerd; Giampiero Bricca; Hugues Milon; Madeleine Vincent; Pierre Lantelme |
Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-3-7 |
Journal Detail:
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Title: Hypertension Volume: - ISSN: 1524-4563 ISO Abbreviation: - Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-3-8 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7906255 Medline TA: Hypertension Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Cardiology Department, European Society of Hypertension Excellence Center, and Metabolic and Endocrine Exploration Laboratory, Hôpital de la Croix-Rousse, Hospices Civils de Lyon, Lyon, France; Claude Bernard University Lyon 1, Université de Lyon, Villeurbanne, France; Institut National de la Santé et de la Recherche Médicale ERI 22, Lyon, France. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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