Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Hanyang University Guri Hospital, 153 Gyeongchun-ro, Guri, Gyeonggi-do, 11923, Republic of Korea.
Division of Cardiology, Department of Internal Medicine, Hanyang University College of Medicine, Hanyang University Seoul Hospital, Seoul, Republic of Korea.
Sci Rep. 2022 Dec 5;12(1):21001. doi: 10.1038/s41598-022-25705-1.
B-type natriuretic peptide (BNP) is a well-established prognostic factor for cardiovascular disorders. However, the association between BNP levels and mortality in patients with acute severe hypertension remains unclear. This study aimed to investigate the association between BNP levels and long-term mortality in patients with acute severe hypertension visiting the emergency department (ED). This retrospective study included patients aged ≥ 18 years who were admitted to the ED between 2016 and 2019 with acute severe hypertension (systolic blood pressure ≥ 180 mmHg or diastolic blood pressure ≥ 100 mmHg). Patients were categorized into tertiles according to BNP levels upon admission to the ED. Of the 3099 patients with acute severe hypertension, 6.4% in the first (lowest) tertile, 24.8% in the second tertile, and 44.4% in the third (highest) tertile of BNP died within 3-years. After adjusting for clinically relevant variables, patients in the second tertile of BNP (adjusted hazard ratio [HR], 2.64; 95% confidence interval [CI], 1.96-3.55), and patients in the third tertile of BNP (adjusted HR 4.18; 95% CI, 3.09-5.64) had a significantly higher risk of 3-year all-cause mortality than those in the first tertile of BNP. Therefore, BNP may be valuable for the initial assessment to identify high-risk patients among those with acute severe hypertension.
B 型利钠肽（BNP）是心血管疾病的一个公认的预后因素。然而，BNP 水平与急性重度高血压患者死亡率之间的关系尚不清楚。本研究旨在探讨急诊就诊的急性重度高血压患者 BNP 水平与长期死亡率之间的关系。本回顾性研究纳入了 2016 年至 2019 年期间因急性重度高血压（收缩压≥180mmHg 或舒张压≥100mmHg）入住急诊的年龄≥18 岁的患者。根据入院时的 BNP 水平，将患者分为三部分。在 3099 例急性重度高血压患者中，第 1 部分（最低）BNP 水平的患者中有 6.4%，第 2 部分的患者中有 24.8%，第 3 部分（最高）BNP 水平的患者中有 44.4%在 3 年内死亡。在校正了临床相关变量后，BNP 第 2 部分（调整后的危险比[HR]，2.64；95%置信区间[CI]，1.96-3.55）和 BNP 第 3 部分（调整后的 HR，4.18；95%CI，3.09-5.64）的患者 3 年全因死亡率的风险显著高于 BNP 第 1 部分的患者。因此，BNP 可能对识别急性重度高血压患者中的高危患者具有初始评估价值。
