Nirav Patel1, Orlando M Gutiérrez2, Garima Arora1, George Howard3, Virginia J Howard4, Suzanne E Judd3, Sumanth D Prabhu5, Emily B Levitan4, Mary Cushman6, Pankaj Arora7. 1. Division of Cardiovascular Disease, University of Alabama at Birmingham, 1900 University Blvd., Birmingham, AL, USA. 2. 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. 3. Department of Biostatistics, University of Alabama at Birmingham, 1665 University Blvd., Birmingham, AL, USA. 4. Department of Epidemiology, University of Alabama at Birmingham, 1655 University Blvd., Birmingham, AL, USA. 5. 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. 6. 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. 7. 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. Electronic address: parora@uabmc.edu.
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.
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.
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