Brain natriuretic peptide as a marker of cardiac involvement in hypertension

Hypertensive patients with heart abnormalities have increased risk of cardi ovascular events. Brain natriuretic peptide is a natriuretic peptide mainly of ventricular origin produced in response to pressure and stretch. We hyp othesise that brain natriuretic peptide could be a useful marker of cardiac remodelling in hypertensive patients. We studied 36 consecutive community mild-to-moderate hypertensive patients and 11 well-matched normotensive con trols with respect to clinical characteristics, brain natriuretic peptide, creatinine and echocardiography parameters (M-mode, 2-D arid transmitral pu lsed Doppler). Brain natriuretic peptide levels were significantly higher i n hypertensive patients than in controls [36.54 (IQR: 38.61) vs. 10.30 (IQR : 13.20) pg ml(-1), p<0.0001] and it was correlated with left ventricular m ass index. Hypertensive patients with impairment of diastolic filling had s ignificantly higher brain natriuretic peptide concentrations than patients with no abnormalities on echocardiography [61.16 (45.38) vs. 31.27 (18.10) pg ml(-1), p=0.001]. Multivariate analysis showed that only diastolic dysfu nction and left ventricular mass index were significantly and independently related with brain natriuretic peptide concentrations in this population. In conclusion, impairment of diastolic function and left ventricular mass i ndex are related to brain natriuretic peptide levels, thus giving the insig ht that this peptide can be a marker of ventricular remodelling in hyperten sive patients. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.