TY - JOUR
T1 - Influence of sex and hormone status on circulating natriuretic peptides
AU - Lam, Carolyn S.P.
AU - Cheng, Susan
AU - Choong, Karen
AU - Larson, Martin G.
AU - Murabito, Joanne M.
AU - Newton-Cheh, Christopher
AU - Bhasin, Shalender
AU - McCabe, Elizabeth L.
AU - Miller, Karen K.
AU - Redfield, Margaret M.
AU - Vasan, Ramachandran S.
AU - Coviello, Andrea D.
AU - Wang, Thomas J.
N1 - Funding Information:
This study is from the Framingham Heart Study of the National Heart, Lung and Blood Institute of the National Institutes of Health and Boston University School of Medicine, and is supported by NIH/NHLBI NO1-HC-25195, R01-HL-086875, and R01-HL-094755. Dr. Newton-Cheh serves on a scientific advisory board at Merck. Dr. Redfield is supported by HL-84907. All other authors have reported that they have no relationships to disclose. Drs. Coviello and Wang contributed equally to this work.
PY - 2011/8/2
Y1 - 2011/8/2
N2 - Objectives: The aim of this study was to assess the relationship between sex hormones and natriuretic peptide levels in community-based adults. Background: Women have higher circulating natriuretic peptide concentrations than men, but the mechanisms for these sex-related differences and the impact of hormone therapy are unclear. Experimental studies suggest that androgens may suppress natriuretic peptide secretion. Methods: We measured N-terminal proB-type natriuretic peptide (NT-proBNP), total testosterone, and sex hormonebinding globulin plasma levels in 4,056 men and women (mean age 40 ± 9 years) from the Framingham Heart Study Third-Generation cohort. Sex/hormone status was grouped as: 1) men; 2) post-menopausal women not receiving hormone replacement therapy; 3) pre-menopausal women not receiving hormonal contraceptives; 4) post-menopausal women receiving hormone replacement therapy; and 5) pre-menopausal women receiving hormonal contraceptives. Results: Circulating NT-proBNP levels were associated with sex/hormone status (overall p < 0.0001). Men had lower NT-proBNP levels than women of all menopause or hormone groups, and women receiving hormonal contraceptives had higher NT-proBNP levels than women who were not receiving hormone therapy (all p < 0.0001). These relationships remained significant after adjusting for age, body mass index, and cardiovascular risk factors. Across sex/hormone status groups, free testosterone (FT) levels decreased and sex hormonebinding globulin levels increased in tandem with increasing NT-proBNP levels. In sex-specific analyses, NT-proBNP levels decreased across increasing quartiles of FT in men (p for trend <0.01) and women (p for trend <0.0001). Adjustment for FT markedly attenuated the association between sex/hormone status and NT-proBNP concentrations. Conclusions: These findings suggest that lower levels of circulating androgens and the potentiating effect of exogenous female hormone therapy contribute to the higher circulating NT-proBNP concentrations in women.
AB - Objectives: The aim of this study was to assess the relationship between sex hormones and natriuretic peptide levels in community-based adults. Background: Women have higher circulating natriuretic peptide concentrations than men, but the mechanisms for these sex-related differences and the impact of hormone therapy are unclear. Experimental studies suggest that androgens may suppress natriuretic peptide secretion. Methods: We measured N-terminal proB-type natriuretic peptide (NT-proBNP), total testosterone, and sex hormonebinding globulin plasma levels in 4,056 men and women (mean age 40 ± 9 years) from the Framingham Heart Study Third-Generation cohort. Sex/hormone status was grouped as: 1) men; 2) post-menopausal women not receiving hormone replacement therapy; 3) pre-menopausal women not receiving hormonal contraceptives; 4) post-menopausal women receiving hormone replacement therapy; and 5) pre-menopausal women receiving hormonal contraceptives. Results: Circulating NT-proBNP levels were associated with sex/hormone status (overall p < 0.0001). Men had lower NT-proBNP levels than women of all menopause or hormone groups, and women receiving hormonal contraceptives had higher NT-proBNP levels than women who were not receiving hormone therapy (all p < 0.0001). These relationships remained significant after adjusting for age, body mass index, and cardiovascular risk factors. Across sex/hormone status groups, free testosterone (FT) levels decreased and sex hormonebinding globulin levels increased in tandem with increasing NT-proBNP levels. In sex-specific analyses, NT-proBNP levels decreased across increasing quartiles of FT in men (p for trend <0.01) and women (p for trend <0.0001). Adjustment for FT markedly attenuated the association between sex/hormone status and NT-proBNP concentrations. Conclusions: These findings suggest that lower levels of circulating androgens and the potentiating effect of exogenous female hormone therapy contribute to the higher circulating NT-proBNP concentrations in women.
KW - hormones
KW - natriuretic peptides
KW - sex
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U2 - 10.1016/j.jacc.2011.03.042
DO - 10.1016/j.jacc.2011.03.042
M3 - Article
C2 - 21798425
AN - SCOPUS:79960924613
VL - 58
SP - 618
EP - 626
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
SN - 0735-1097
IS - 6
ER -