ATRIAL NATRIURETIC PEPTIDES PREDICT MORTALITY IN THE ELDERLY

Objectives. To ascertain whether atrial natriuretic peptides could be used as prospective and independent predictors of total mortality in a n elderly population. Design. Atrial natriuretic peptides, ANP(1-98) a nd ANP(99-126), were measured in 541 subjects from the 85-year-old pop ulation of Gothenburg, Sweden. Before the study cardiovascular disorde rs such as congestive heart failure, ischaemic heart disease, hyperten sion and atrial fibrillation were defined. Total mortality was recorde d during the prospective 60-month follow-up period. Setting. Individua ls aged 85 years from the population of Gothenburg, Sweden, were visit ed once at home and made one visit to Vasa Hospital. Main outcome meas ures. Sixty-month mortality in relation to circulating concentrations of atrial natriuretic peptides. Results. Circulating concentrations of ANP(1-98) and ANP(99-126) were significantly correlated with 60-month mortality in the total study population (ANP(1-98), P < 0.001; ANP(99 -126), P < 0.01). In subjects with cardiovascular disorders, 60-month mortality was significantly correlated with increased concentrations o f ANP(1-98) (P < 0.01) and ANP(99-126) (P < 0.05). In subjects with no defined cardiovascular disorder, 60-month mortality was significantly correlated with increased ANP(1-98) concentrations (P < 0.01). Conclu sions. In the elderly population, atrial peptides predict mortality in subjects with defined cardiovascular disorders as well as in the tota l population and may predict future cardiovascular disorder.