Deepak K Gupta1, James A de Lemos2, Colby R Ayers3, Jarett D Berry3, Thomas J Wang4. 1. Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University Medical Center, Nashville, Tennessee; Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee. Electronic address: d.gupta@vanderbilt.edu. 2. Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas. 3. Department of Internal Medicine, Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas; Department of Clinical Sciences, University of Texas Southwestern Medical Center, Dallas, Texas. 4. Vanderbilt Translational and Clinical Cardiovascular Research Center, Vanderbilt University Medical Center, Nashville, Tennessee; Division of Cardiovascular Medicine, Vanderbilt University Medical Center, Nashville, Tennessee.
Abstract
OBJECTIVES: The purpose of this study was to assess whether N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels differ according to race/ethnicity. BACKGROUND: Natriuretic peptides (NP) are hormones with natriuretic, diuretic, and vasodilatory effects. Experimental NP deficiency promotes salt-sensitive hypertension and cardiac hypertrophy, conditions that are more common among black individuals. METHODS: We examined plasma NT-proBNP levels according to race/ethnicity in 3,148 individuals (51% black, 31% white, 18% Hispanic) free of prevalent cardiovascular disease in the Dallas Heart Study. NT-proBNP values in the bottom sex-specific quartile were defined as low. Multivariable linear and logistic regression analyses were performed adjusting for clinical covariates and magnetic resonance imaging measurements of cardiac structure and function. RESULTS: Hypertension was present in 41%, 25%, and 16% of black, white, and Hispanic individuals, respectively. Unadjusted NT-proBNP levels were lowest in black (median: 24 pg/ml; interquartile range [IQR]: 10 to 52 pg/ml) as compared with Hispanic (30 pg/ml; IQR: 14 to 59 pg/ml) and white individuals (32 pg/ml; IQR: 16 to 62 pg/ml), p < 0.0001. In multivariable-adjusted models, black individuals still had significantly lower NT-proBNP levels (-39% [95% confidence interval: -46% to -31%]; p < 0.0001) and greater odds of having low NT-proBNP (odds ratio: 2.46 [95% confidence interval: 1.86 to 3.26]), compared with white individuals. In contrast, NT-proBNP levels did not significantly differ between Hispanic and white individuals (p = 0.28). The finding of lower NT-proBNP levels in black individuals was similar when analyses were restricted to healthy participants without cardiovascular risk factors. CONCLUSIONS: In this multiethnic cohort, NT-proBNP levels differ substantially according to race/ethnicity. Despite a higher prevalence of hypertension, black individuals had significantly lower NP levels than white and Hispanic individuals. A relative NP "deficiency" among black individuals may lead to greater susceptibility to salt retention and hypertension.
OBJECTIVES: The purpose of this study was to assess whether N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels differ according to race/ethnicity. BACKGROUND: Natriuretic peptides (NP) are hormones with natriuretic, diuretic, and vasodilatory effects. Experimental NP deficiency promotes salt-sensitive hypertension and cardiac hypertrophy, conditions that are more common among black individuals. METHODS: We examined plasma NT-proBNP levels according to race/ethnicity in 3,148 individuals (51% black, 31% white, 18% Hispanic) free of prevalent cardiovascular disease in the Dallas Heart Study. NT-proBNP values in the bottom sex-specific quartile were defined as low. Multivariable linear and logistic regression analyses were performed adjusting for clinical covariates and magnetic resonance imaging measurements of cardiac structure and function. RESULTS:Hypertension was present in 41%, 25%, and 16% of black, white, and Hispanic individuals, respectively. Unadjusted NT-proBNP levels were lowest in black (median: 24 pg/ml; interquartile range [IQR]: 10 to 52 pg/ml) as compared with Hispanic (30 pg/ml; IQR: 14 to 59 pg/ml) and white individuals (32 pg/ml; IQR: 16 to 62 pg/ml), p < 0.0001. In multivariable-adjusted models, black individuals still had significantly lower NT-proBNP levels (-39% [95% confidence interval: -46% to -31%]; p < 0.0001) and greater odds of having low NT-proBNP (odds ratio: 2.46 [95% confidence interval: 1.86 to 3.26]), compared with white individuals. In contrast, NT-proBNP levels did not significantly differ between Hispanic and white individuals (p = 0.28). The finding of lower NT-proBNP levels in black individuals was similar when analyses were restricted to healthy participants without cardiovascular risk factors. CONCLUSIONS: In this multiethnic cohort, NT-proBNP levels differ substantially according to race/ethnicity. Despite a higher prevalence of hypertension, black individuals had significantly lower NP levels than white and Hispanic individuals. A relative NP "deficiency" among black individuals may lead to greater susceptibility to saltretention and hypertension.
Authors: Lori B Daniels; Paul Clopton; Mihael Potocki; Christian Mueller; James McCord; Mark Richards; Oliver Hartmann; Inder S Anand; Alan H B Wu; Richard Nowak; W Frank Peacock; Piotr Ponikowski; Martin Mockel; Christopher Hogan; Gerasimos S Filippatos; Salvatore Di Somma; Leong Ng; Sean-Xavier Neath; Robert Christenson; Nils G Morgenthaler; Stefan D Anker; Alan S Maisel Journal: Eur J Heart Fail Date: 2011-12-02 Impact factor: 15.534
Authors: Susan Cheng; Caroline S Fox; Martin G Larson; Joseph M Massaro; Elizabeth L McCabe; Abigail May Khan; Daniel Levy; Udo Hoffmann; Christopher J O'Donnell; Karen K Miller; Christopher Newton-Cheh; Andrea D Coviello; Shalender Bhasin; Ramachandran S Vasan; Thomas J Wang Journal: Am J Cardiol Date: 2011-08-01 Impact factor: 2.778
Authors: Ervin R Fox; Solomon K Musani; Aurelian Bidulescu; Harsha S Nagarajarao; Tandaw E Samdarshi; Samson Y Gebreab; Jung Hye Sung; Michael W Steffes; Thomas J Wang; Herman A Taylor; Ramachandran S Vasan Journal: Circulation Date: 2011-08-08 Impact factor: 29.690
Authors: Abigail May Khan; Susan Cheng; Martin Magnusson; Martin G Larson; Christopher Newton-Cheh; Elizabeth L McCabe; Andrea D Coviello; Jose C Florez; Caroline S Fox; Daniel Levy; Sander J Robins; Pankaj Arora; Shalender Bhasin; Carolyn S P Lam; Ramachandran S Vasan; Olle Melander; Thomas J Wang Journal: J Clin Endocrinol Metab Date: 2011-08-17 Impact factor: 5.958
Authors: John J V McMurray; Milton Packer; Akshay S Desai; Jianjian Gong; Martin P Lefkowitz; Adel R Rizkala; Jean L Rouleau; Victor C Shi; Scott D Solomon; Karl Swedberg; Michael R Zile Journal: N Engl J Med Date: 2014-08-30 Impact factor: 91.245
Authors: Milton Packer; John J V McMurray; Akshay S Desai; Jianjian Gong; Martin P Lefkowitz; Adel R Rizkala; Jean L Rouleau; Victor C Shi; Scott D Solomon; Karl Swedberg; Michael Zile; Karl Andersen; Juan Luis Arango; J Malcolm Arnold; Jan Bělohlávek; Michael Böhm; Sergey Boytsov; Lesley J Burgess; Walter Cabrera; Carlos Calvo; Chen-Huan Chen; Andrej Dukat; Yan Carlos Duarte; Andrejs Erglis; Michael Fu; Efrain Gomez; Angel Gonzàlez-Medina; Albert A Hagège; Jun Huang; Tzvetana Katova; Songsak Kiatchoosakun; Kee-Sik Kim; Ömer Kozan; Edmundo Bayram Llamas; Felipe Martinez; Bela Merkely; Iván Mendoza; Arend Mosterd; Marta Negrusz-Kawecka; Keijo Peuhkurinen; Felix J A Ramires; Jens Refsgaard; Arvo Rosenthal; Michele Senni; Antonio S Sibulo; José Silva-Cardoso; Iain B Squire; Randall C Starling; John R Teerlink; Johan Vanhaecke; Dragos Vinereanu; Raymond Ching-Chiew Wong Journal: Circulation Date: 2014-11-17 Impact factor: 29.690
Authors: Georg B Ehret; Patricia B Munroe; Kenneth M Rice; Murielle Bochud; Andrew D Johnson; Daniel I Chasman; Albert V Smith; Martin D Tobin; Germaine C Verwoert; Shih-Jen Hwang; Vasyl Pihur; Peter Vollenweider; Paul F O'Reilly; Najaf Amin; Jennifer L Bragg-Gresham; Alexander Teumer; Nicole L Glazer; Lenore Launer; Jing Hua Zhao; Yurii Aulchenko; Simon Heath; Siim Sõber; Afshin Parsa; Jian'an Luan; Pankaj Arora; Abbas Dehghan; Feng Zhang; Gavin Lucas; Andrew A Hicks; Anne U Jackson; John F Peden; Toshiko Tanaka; Sarah H Wild; Igor Rudan; Wilmar Igl; Yuri Milaneschi; Alex N Parker; Cristiano Fava; John C Chambers; Ervin R Fox; Meena Kumari; Min Jin Go; Pim van der Harst; Wen Hong Linda Kao; Marketa Sjögren; D G Vinay; Myriam Alexander; Yasuharu Tabara; Sue Shaw-Hawkins; Peter H Whincup; Yongmei Liu; Gang Shi; Johanna Kuusisto; Bamidele Tayo; Mark Seielstad; Xueling Sim; Khanh-Dung Hoang Nguyen; Terho Lehtimäki; Giuseppe Matullo; Ying Wu; Tom R Gaunt; N Charlotte Onland-Moret; Matthew N Cooper; Carl G P Platou; Elin Org; Rebecca Hardy; Santosh Dahgam; Jutta Palmen; Veronique Vitart; Peter S Braund; Tatiana Kuznetsova; Cuno S P M Uiterwaal; Adebowale Adeyemo; Walter Palmas; Harry Campbell; Barbara Ludwig; Maciej Tomaszewski; Ioanna Tzoulaki; Nicholette D Palmer; Thor Aspelund; Melissa Garcia; Yen-Pei C Chang; Jeffrey R O'Connell; Nanette I Steinle; Diederick E Grobbee; Dan E Arking; Sharon L Kardia; Alanna C Morrison; Dena Hernandez; Samer Najjar; Wendy L McArdle; David Hadley; Morris J Brown; John M Connell; Aroon D Hingorani; Ian N M Day; Debbie A Lawlor; John P Beilby; Robert W Lawrence; Robert Clarke; Jemma C Hopewell; Halit Ongen; Albert W Dreisbach; Yali Li; J Hunter Young; Joshua C Bis; Mika Kähönen; Jorma Viikari; Linda S Adair; Nanette R Lee; Ming-Huei Chen; Matthias Olden; Cristian Pattaro; Judith A Hoffman Bolton; Anna Köttgen; Sven Bergmann; Vincent Mooser; Nish Chaturvedi; Timothy M Frayling; Muhammad Islam; Tazeen H Jafar; Jeanette Erdmann; Smita R Kulkarni; Stefan R Bornstein; Jürgen Grässler; Leif Groop; Benjamin F Voight; Johannes Kettunen; Philip Howard; Andrew Taylor; Simonetta Guarrera; Fulvio Ricceri; Valur Emilsson; Andrew Plump; Inês Barroso; Kay-Tee Khaw; Alan B Weder; Steven C Hunt; Yan V Sun; Richard N Bergman; Francis S Collins; Lori L Bonnycastle; Laura J Scott; Heather M Stringham; Leena Peltonen; Markus Perola; Erkki Vartiainen; Stefan-Martin Brand; Jan A Staessen; Thomas J Wang; Paul R Burton; Maria Soler Artigas; Yanbin Dong; Harold Snieder; Xiaoling Wang; Haidong Zhu; Kurt K Lohman; Megan E Rudock; Susan R Heckbert; Nicholas L Smith; Kerri L Wiggins; Ayo Doumatey; Daniel Shriner; Gudrun Veldre; Margus Viigimaa; Sanjay Kinra; Dorairaj Prabhakaran; Vikal Tripathy; Carl D Langefeld; Annika Rosengren; Dag S Thelle; Anna Maria Corsi; Andrew Singleton; Terrence Forrester; Gina Hilton; Colin A McKenzie; Tunde Salako; Naoharu Iwai; Yoshikuni Kita; Toshio Ogihara; Takayoshi Ohkubo; Tomonori Okamura; Hirotsugu Ueshima; Satoshi Umemura; Susana Eyheramendy; Thomas Meitinger; H-Erich Wichmann; Yoon Shin Cho; Hyung-Lae Kim; Jong-Young Lee; James Scott; Joban S Sehmi; Weihua Zhang; Bo Hedblad; Peter Nilsson; George Davey Smith; Andrew Wong; Narisu Narisu; Alena Stančáková; Leslie J Raffel; Jie Yao; Sekar Kathiresan; Christopher J O'Donnell; Stephen M Schwartz; M Arfan Ikram; W T Longstreth; Thomas H Mosley; Sudha Seshadri; Nick R G Shrine; Louise V Wain; Mario A Morken; Amy J Swift; Jaana Laitinen; Inga Prokopenko; Paavo Zitting; Jackie A Cooper; Steve E Humphries; John Danesh; Asif Rasheed; Anuj Goel; Anders Hamsten; Hugh Watkins; Stephan J L Bakker; Wiek H van Gilst; Charles S Janipalli; K Radha Mani; Chittaranjan S Yajnik; Albert Hofman; Francesco U S Mattace-Raso; Ben A Oostra; Ayse Demirkan; Aaron Isaacs; Fernando Rivadeneira; Edward G Lakatta; Marco Orru; Angelo Scuteri; Mika Ala-Korpela; Antti J Kangas; Leo-Pekka Lyytikäinen; Pasi Soininen; Taru Tukiainen; Peter Würtz; Rick Twee-Hee Ong; Marcus Dörr; Heyo K Kroemer; Uwe Völker; Henry Völzke; Pilar Galan; Serge Hercberg; Mark Lathrop; Diana Zelenika; Panos Deloukas; Massimo Mangino; Tim D Spector; Guangju Zhai; James F Meschia; Michael A Nalls; Pankaj Sharma; Janos Terzic; M V Kranthi Kumar; Matthew Denniff; Ewa Zukowska-Szczechowska; Lynne E Wagenknecht; F Gerald R Fowkes; Fadi J Charchar; Peter E H Schwarz; Caroline Hayward; Xiuqing Guo; Charles Rotimi; Michiel L Bots; Eva Brand; Nilesh J Samani; Ozren Polasek; Philippa J Talmud; Fredrik Nyberg; Diana Kuh; Maris Laan; Kristian Hveem; Lyle J Palmer; Yvonne T van der Schouw; Juan P Casas; Karen L Mohlke; Paolo Vineis; Olli Raitakari; Santhi K Ganesh; Tien Y Wong; E Shyong Tai; Richard S Cooper; Markku Laakso; Dabeeru C Rao; Tamara B Harris; Richard W Morris; Anna F Dominiczak; Mika Kivimaki; Michael G Marmot; Tetsuro Miki; Danish Saleheen; Giriraj R Chandak; Josef Coresh; Gerjan Navis; Veikko Salomaa; Bok-Ghee Han; Xiaofeng Zhu; Jaspal S Kooner; Olle Melander; Paul M Ridker; Stefania Bandinelli; Ulf B Gyllensten; Alan F Wright; James F Wilson; Luigi Ferrucci; Martin Farrall; Jaakko Tuomilehto; Peter P Pramstaller; Roberto Elosua; Nicole Soranzo; Eric J G Sijbrands; David Altshuler; Ruth J F Loos; Alan R Shuldiner; Christian Gieger; Pierre Meneton; Andre G Uitterlinden; Nicholas J Wareham; Vilmundur Gudnason; Jerome I Rotter; Rainer Rettig; Manuela Uda; David P Strachan; Jacqueline C M Witteman; Anna-Liisa Hartikainen; Jacques S Beckmann; Eric Boerwinkle; Ramachandran S Vasan; Michael Boehnke; Martin G Larson; Marjo-Riitta Järvelin; Bruce M Psaty; Gonçalo R Abecasis; Aravinda Chakravarti; Paul Elliott; Cornelia M van Duijn; Christopher Newton-Cheh; Daniel Levy; Mark J Caulfield; Toby Johnson Journal: Nature Date: 2011-09-11 Impact factor: 49.962
Authors: Nirav Patel; Mary Cushman; Orlando M Gutiérrez; George Howard; Monika M Safford; Paul Muntner; Raegan W Durant; Sumanth D Prabhu; Garima Arora; Emily B Levitan; Pankaj Arora Journal: JCI Insight Date: 2019-06-04
Authors: Sushan Yang; Shi Huang; Lori B Daniels; Joseph Yeboah; Joao A C Lima; Valentina Cannone; John C Burnett; Joshua A Beckman; J Jeffrey Carr; Thomas J Wang; Deepak K Gupta Journal: Heart Date: 2019-05-31 Impact factor: 5.994
Authors: Deepak K Gupta; Lori B Daniels; Susan Cheng; Christopher R deFilippi; Michael H Criqui; Alan S Maisel; Joao A Lima; Hossein Bahrami; Philip Greenland; Mary Cushman; Russell Tracy; David Siscovick; Alain G Bertoni; Valentina Cannone; John C Burnett; John Jeffrey Carr; Thomas J Wang Journal: Am J Cardiol Date: 2017-06-30 Impact factor: 2.778
Authors: Alana A Lewis; Colby R Ayers; Elizabeth Selvin; Ian Neeland; Christie M Ballantyne; Vijay Nambi; Ambarish Pandey; Tiffany M Powell-Wiley; Mark H Drazner; Mercedes R Carnethon; Jarett D Berry; Stephen L Seliger; Christopher R DeFilippi; James A de Lemos Journal: Circulation Date: 2020-01-14 Impact factor: 29.690
Authors: Yejin Mok; Yingying Sang; Shoshana H Ballew; Ron C Hoogeveen; Christie M Ballantyne; Wayne Rosamond; Josef Coresh; Elizabeth Selvin; Kunihiro Matsushita Journal: Am Heart J Date: 2019-07-13 Impact factor: 4.749
Authors: Iuliia Polina; Mark Domondon; Rebecca Fox; Anastasia V Sudarikova; Miguel Troncoso; Valeriia Y Vasileva; Yuliia Kashyrina; Monika Beck Gooz; Ryan S Schibalski; Kristine Y DeLeon-Pennell; Wayne R Fitzgibbon; Daria V Ilatovskaya Journal: Am J Physiol Renal Physiol Date: 2020-05-28