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N 端脑利钠肽前体与老年人血压和脉压的关系——一项横断面人群研究。

Association of N-Terminal Pro B-Type Natriuretic Peptide With Blood Pressure and Pulse Pressure in Elderly People - A Cross-Sectional Population Study.

机构信息

Health Management and Promotion Center, Hiroshima Atomic Bomb Casualty Council.

Department of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical and Health Sciences.

出版信息

Circ J. 2018 Jul 25;82(8):2049-2054. doi: 10.1253/circj.CJ-18-0031. Epub 2018 May 23.

Abstract

BACKGROUND

N-Terminal pro B-type natriuretic peptide (NT-proBNP) is widely used as a marker of ventricular dysfunction. However, data regarding the association of NT-proBNP with blood pressure (BP) and pulse pressure (PP) in the elderly population are limited.

METHODS AND RESULTS

The present cross-sectional study involved 6,529 participants, aged ≥70 years, without cardiovascular disease (CVD), who underwent general health examinations. Serum NT-proBNP concentrations were determined, with high NT-proBNP concentrations defined as those ≥125 pg/mL. Subjects were divided into five groups based on PP (<50, ≥50 to <60, ≥60 to <70, ≥70 to <80, and ≥80 mmHg). NT-proBNP was positively associated with systolic BP, whereas a U-shaped association was found between diastolic BP and NT-proBNP. The odds ratios for high NT-proBNP concentrations in the PP ≥80 and ≥70 to <80 mmHg groups (OR 1.83 [P<0.001] and 1.40 [P<0.005], respectively) were significantly higher than in the PP <50 mmHg group. All data were adjusted for age, sex, body mass index, hemoglobin concentration, serum creatinine, pulse rate, smoking, alcohol intake, and antihypertensive medication intake, and the presence of diabetes and dyslipidemia.

CONCLUSIONS

The results suggest that NT-proBNP concentrations may be a marker of not only ventricular dysfunction, but also arterial stiffness in the elderly population without CVD.

摘要

背景

N 端脑利钠肽前体(NT-proBNP)被广泛用作心室功能障碍的标志物。然而,关于 NT-proBNP 与老年人血压(BP)和脉压(PP)之间的关联的数据有限。

方法和结果

本横断面研究纳入了 6529 名年龄≥70 岁、无心血管疾病(CVD)的受试者,他们接受了全面健康检查。测定血清 NT-proBNP 浓度,将高 NT-proBNP 浓度定义为≥125pg/mL。根据 PP(<50、≥50 至<60、≥60 至<70、≥70 至<80 和≥80mmHg)将受试者分为五组。NT-proBNP 与收缩压呈正相关,而舒张压与 NT-proBNP 呈 U 形相关。PP≥80mmHg 和≥70 至<80mmHg 组中 NT-proBNP 浓度高的比值比(OR)分别为 1.83(P<0.001)和 1.40(P<0.005),明显高于 PP<50mmHg 组。所有数据均经年龄、性别、体重指数、血红蛋白浓度、血清肌酐、脉搏率、吸烟、饮酒和抗高血压药物的使用以及糖尿病和血脂异常的存在调整。

结论

结果表明,NT-proBNP 浓度不仅可能是心室功能障碍的标志物,而且可能是无 CVD 的老年人群动脉僵硬的标志物。

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