BRAIN NATRIURETIC PEPTIDE IN AN ELDERLY POPULATION

Objectives. To study the relationship of brain natriuretic peptide con centrations to ageing, and whether brain natriuretic peptide could ref lect current disease states in the general elderly population. Design, Brain natriuretic peptide was measured in two population samples from the general population. Subjects. Five hundred forty-five 85-year-old subjects from the longitudinal population study '70-year-old people i n Gothenburg, Sweden' were investigated in respect to cardiovascular, renal and metabolic disease, and 191 subjects from the 40-year-old mal e population were examined. Main outcome measures. To study the influe nce of ageing on circulating brain natriuretic peptide and the associa tion between concentrations of brain natriuretic peptide and common di sease states in the elderly. Results, Brain natriuretic peptide concen trations were significantly increased in relation to ageing (P < 0.001 ). Brain natriuretic peptide concentrations were significantly increas ed in elderly with congestive heart failure (P < 0.001), ischaemic hea rt disease (P < 0.001), atrial fibrillation (P < 0.001) and renal dysf unction (P < 0.001) but not in hypertension. In multivariate analysis, brain natriuretic peptide concentrations were predictive for ischaemi c heart disease (P < 0.001), atrial fibrillation (P < 0.01), renal dys function (P < 0.01), congestive heart failure (P < 0.05) and treatment with beta-adrenergic blockers (P < 0.05). Conclusions, Plasma concent rations of brain natriuretic peptide are increased in healthy elderly compared to middle-aged individuals. In the elderly, measurements of b rain natriuretic peptide may provide prognostic information, due to th e augmented secretion in cardiovascular diseases commonly seen in this population. It remains to be determined whether routine measurements of circulating brain natriuretic peptide will be of value in predictin g current cardiovascular disease for the individual patient.