Open AccessRacial Differences in Circulating Natriuretic Peptide Levels: The Atherosclerosis Risk in Communities Study
Author(s) -
Gupta Deepak K.,
Claggett Brian,
Wells Quinn,
Cheng Susan,
Li Man,
Maruthur Nisa,
Selvin Elizabeth,
Coresh Josef,
Konety Suma,
Butler Kenneth R.,
Mosley Thomas,
Boerwinkle Eric,
Hoogeveen Ron,
Ballantyne Christie M.,
Solomon Scott D.
Publication year - 2015
Publication title -
journal of the american heart association
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.494
H-Index - 85
ISSN - 2047-9980
DOI - 10.1161/jaha.115.001831
Subject(s) - medicine , interquartile range , natriuretic peptide , confidence interval , genetic genealogy , atherosclerosis risk in communities , endocrinology , diabetes mellitus , logistic regression , cardiology , heart failure , population , environmental health
Background Natriuretic peptides promote natriuresis, diuresis, and vasodilation. Experimental deficiency of natriuretic peptides leads to hypertension ( HTN ) and cardiac hypertrophy, conditions more common among African Americans. Hospital‐based studies suggest that African Americans may have reduced circulating natriuretic peptides, as compared to Caucasians, but definitive data from community‐based cohorts are lacking. Methods and Results We examined plasma N‐terminal pro B‐type natriuretic peptide ( NT pro BNP ) levels according to race in 9137 Atherosclerosis Risk in Communities ( ARIC ) Study participants (22% African American) without prevalent cardiovascular disease at visit 4 (1996–1998). Multivariable linear and logistic regression analyses were performed adjusting for clinical covariates. Among African Americans, percent European ancestry was determined from genetic ancestry informative markers and then examined in relation to NT pro BNP levels in multivariable linear regression analysis. NT pro BNP levels were significantly lower in African Americans (median, 43 pg/ mL ; interquartile range [ IQR ], 18, 88) than Caucasians (median, 68 pg/ mL ; IQR , 36, 124; P <0.0001). In multivariable models, adjusted log NT pro BNP levels were 40% lower (95% confidence interval [ CI ], −43, −36) in African Americans, compared to Caucasians, which was consistent across subgroups of age, gender, HTN , diabetes, insulin resistance, and obesity. African‐American race was also significantly associated with having nondetectable NT pro BNP (adjusted OR , 5.74; 95% CI , 4.22, 7.80). In multivariable analyses in African Americans, a 10% increase in genetic European ancestry was associated with a 7% (95% CI , 1, 13) increase in adjusted log NT proBNP. Conclusions African Americans have lower levels of plasma NT pro BNP than Caucasians, which may be partially owing to genetic variation. Low natriuretic peptide levels in African Americans may contribute to the greater risk for HTN and its sequalae in this population.