Satoh Michihiro, Hosaka Miki, Asayama Kei, Kikuya Masahiro, Inoue Ryusuke, Metoki Hirohito, Tsubota-Utsugi Megumi, Hara Azusa, Hirose Takuo, Obara Taku, Totsune Kazuhito, Hoshi Haruhisa, Mano Nariyasu, Node Koichi, Imai Yutaka, Ohkubo Takayoshi
aDepartment of Pharmacy, Tohoku University Hospital bDepartment of Planning for Drug Development and Clinical Evaluation, Tohoku University Graduate School of Pharmaceutical Sciences, Sendai cDepartment of Hygiene and Public Health, Teikyo University School of Medicine, Tokyo dTohoku Medical Megabank Organization, Tohoku University eDepartment of Medical Information Technology Center, Tohoku University Hospital, Sendai fNational Institute of Health and Nutrition, Tokyo, Japan gResearch Unit Hypertension and Cardiovascular Epidemiology, KU Leuven Department of Cardiovascular Sciences, Studies Coordinating Centre, University of Leuven, Leuven, Belgium hEarly Development and Pathologies, Center for Interdisciplinary Research in Biology, College de France, Paris, France iFaculty of Synthetic Welfare, Department of Social Welfare, the Tohoku Fukushi University, Sendai jDepartment of Internal Medicine, Ohasama Hospital, Iwate kDepartment of Cardiovascular Medicine, Saga University, Saga, Japan.
J Hypertens. 2015 Aug;33(8):1536-41. doi: 10.1097/HJH.0000000000000570.
In addition to day-to-day variability in blood pressure (BP) or heart rate (HR), N-terminal pro B-type natriuretic peptide (NT-proBNP) has been reported to be a predictor of cardiovascular disease. Here, we tested the hypothesis that day-to-day BP or HR variability calculated as the intraindividual standard deviation (SD) of home BP or HR is associated with elevated NT-proBNP in a cross-sectional study.
Among 664 participants (mean age, 61.9 years; female, 70.5%) from a general Japanese population without a history of heart disease, 86 (13.0%) had NT-proBNP at least 125 pg/ml.
Each 1 SD increase in the SD of home systolic BP (SBP) [odds ratio (OR), 1.82; P < .0001) and in the SD of home HR (OR, 1.44; P = 0.008) were significantly associated with the prevalence of NT-proBNP at least 125 pg/ml after adjustment for possible confounding factors including home SBP and HR. Among the four groups defined by the median SD of home SBP and of home HR, the group with higher SDs in home SBP (≥8.0 mmHg) and HR (≥5.0 bpm) had the greatest OR for the prevalence of NT-proBNP at least 125 pg/ml (OR, 4.80; P = 0007 vs. a reference group with lower SDs of home SBP and HR).
These results suggest that day-to-day variability in BP and HR may be associated with target-organ damage or complications, which can lead to an elevated NT-proBNP level. An elevated NT-proBNP level may be involved in the prognostic significance of day-to-day variability in BP or HR.
除了血压（BP）或心率（HR）的日常变异性外，有报道称N末端B型利钠肽原（NT-proBNP）是心血管疾病的一个预测指标。在此，我们在一项横断面研究中检验了这样一个假设，即作为家庭血压或心率的个体内标准差（SD）计算得出的日常血压或心率变异性与NT-proBNP升高有关。
在664名来自无心脏病史的日本普通人群的参与者中（平均年龄61.9岁；女性占70.5%），86人（13.0%）的NT-proBNP至少为125 pg/ml。
在对包括家庭收缩压（SBP）和心率在内的可能混杂因素进行调整后，家庭收缩压标准差每增加1个标准差[比值比（OR），1.82；P<0.0001]以及家庭心率标准差每增加1个标准差（OR，1.44；P = 0.008）均与NT-proBNP至少为125 pg/ml的患病率显著相关。在根据家庭收缩压和心率的中位数标准差定义的四组中，家庭收缩压（≥8.0 mmHg）和心率（≥5.0 bpm）标准差较高的组NT-proBNP至少为125 pg/ml的患病率的OR最高（OR，4.80；与家庭收缩压和心率标准差较低的参照组相比，P = 0.007）。
这些结果表明，血压和心率的日常变异性可能与靶器官损害或并发症有关，这可能导致NT-proBNP水平升高。NT-proBNP水平升高可能与血压或心率日常变异性的预后意义有关。
