ATRIAL-NATRIURETIC-PEPTIDE LEVELS IN THE ELDERLY - DIFFERENTIATING NORMAL AGING CHANGES FROM DISEASE

Citation
Km. Davis et al., ATRIAL-NATRIURETIC-PEPTIDE LEVELS IN THE ELDERLY - DIFFERENTIATING NORMAL AGING CHANGES FROM DISEASE, The journals of gerontology. Series A, Biological sciences and medical sciences, 51(3), 1996, pp. 95-101
Citations number
37
Categorie Soggetti
Geiatric & Gerontology","Geiatric & Gerontology
ISSN journal
10795006
Volume
51
Issue
3
Year of publication
1996
Pages
95 - 101
Database
ISI
SICI code
1079-5006(1996)51:3<95:ALITE->2.0.ZU;2-K
Abstract
Background. Atrial natriuretic peptide (ANP) levels increase with adva ncing age and in patients with cardiac dysfunction. Previous studies h ave failed to differentiate the elevated ANP levels of normal aging fr om those of cardiac disease. Methods. To differentiate the increased A NP levels seen in normal aging from that of disease, tasting supine AN P was measured in healthy young (n=24), healthy old (n=90), and clinic ally stable bu cardiovascularly diseased old (n=269) residents of a li fe care facility. ANP levels were correlated with physical exam findin gs, blood chemistries, measures of physical and cognitive function, an d medications. Results. ANP levels were almost fourfold higher in the healthy elderly than in the young (11.4+/-1.1 (SEM) vs 3+/-0.3 pmol/L. p <.01), and two-and-one half times higher in the cardiovascular-dise ased elderly than the healthy elderly (29+/-1.9 vs 11.4+/-1.1 pmol L. p <.01). An ANP value of 21 pmol L has a sensitivity of 83% and specif icity of 52% in distinguishing those elders classified as healthy from those classified as having chronic cardiovascular disease. ANP levels had positive univariate correlation with age (even from 70 to 102 yea rs) an systolic blood pressure. ANP rose progressively with increasing numbers of markers of cardiovascular comorbidity. ANP was higher in s ubjects with jugular venous pressure 10 cm, presence of a third heart sound, peripheral edema, artificial cardiac pacemaker, atrial arrhythm ias, and in those taking digoxin diuretics, or nitrates. On multivaria te analysis independent predictors of ANP levels were in descending or der, nitrates, age, diuretics, and atrial arrhythmias. Conclusion. The se data suggest that ANP levels greater than 21 pmol L are associated with cardiovascular comorbidity in a clinically stable elderly cohort.