NT-proBNP, race and endothelial function in the Multi-Ethnic Study of Atherosclerosis

Sushan Yang, Shi Huang, Lori B. Daniels, Joseph Yeboah, Joao A.C. Lima, Valentina Cannone, John C Jr. Burnett, Joshua A. Beckman, J. Jeffrey Carr, Thomas J. Wang, Deepak K. Gupta

Research output: Contribution to journalArticle

Abstract

Objective: Natriuretic peptides (NPs) are hormones with cardioprotective effects. NP levels vary by race; however, the pathophysiological consequences of lower NP levels are not well understood. We aimed to quantify the association between NPs and endothelial function as measured by flow-mediated dilation (FMD) and the contribution of NP levels to racial differences in endothelial function. Methods: In this cross-sectional study of 2938 Multi-Ethnic Study of Atherosclerosis participants (34% Caucasian, 20% African-American, 20% Asian-American and 26% Hispanic) without cardiovascular disease at baseline, multivariable linear regression models were used to examine the association between serum N-terminal pro-B-type NP (NT-proBNP) and natural log-transformed FMD. We also tested whether NT-proBNP mediated the relationship between race and FMD using the product of coefficients method. Results: Among African-American and Chinese-American individuals, lower NT-proBNP levels were associated with lower FMD, β=0.06 (95% CI: 0.03 to 0.09; p<0.001) and β=0.06 (95% CI: 0.02 to 0.09; p=0.002), respectively. Non-significant associations between NT-proBNP and FMD were found in Hispanic and Caucasian individuals. In multivariable models, endothelial function differed by race, with African-American individuals having the lowest FMD compared with Caucasians, p<0.001. Racial differences in FMD among African-Americans and Chinese-Americans were mediated in part by NT-proBNP levels (African-Americans, mediation effect: -0.03(95% CI: -0.05 to -0.01); Chinese-Americans, mediation effect: -0.03(95% CI: -0.05 to -0.01)). Conclusions: Lower NP levels are associated with worse endothelial function among African-Americans and Chinese-Americans. A relative NP deficiency in some racial/ethnic groups may contribute to differences in vascular function.

Original languageEnglish (US)
JournalHeart
DOIs
StatePublished - Jan 1 2019

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Natriuretic Peptides
Dilatation
Asian Americans
Atherosclerosis
African Americans
Hispanic Americans
Linear Models
Ethnic Groups
Blood Vessels
Cardiovascular Diseases
Cross-Sectional Studies
Serum

Keywords

  • cardiac risk factors and prevention
  • epidemiology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

NT-proBNP, race and endothelial function in the Multi-Ethnic Study of Atherosclerosis. / Yang, Sushan; Huang, Shi; Daniels, Lori B.; Yeboah, Joseph; Lima, Joao A.C.; Cannone, Valentina; Burnett, John C Jr.; Beckman, Joshua A.; Carr, J. Jeffrey; Wang, Thomas J.; Gupta, Deepak K.

In: Heart, 01.01.2019.

Research output: Contribution to journalArticle

Yang, S, Huang, S, Daniels, LB, Yeboah, J, Lima, JAC, Cannone, V, Burnett, JCJ, Beckman, JA, Carr, JJ, Wang, TJ & Gupta, DK 2019, 'NT-proBNP, race and endothelial function in the Multi-Ethnic Study of Atherosclerosis', Heart. https://doi.org/10.1136/heartjnl-2019-314707
Yang, Sushan ; Huang, Shi ; Daniels, Lori B. ; Yeboah, Joseph ; Lima, Joao A.C. ; Cannone, Valentina ; Burnett, John C Jr. ; Beckman, Joshua A. ; Carr, J. Jeffrey ; Wang, Thomas J. ; Gupta, Deepak K. / NT-proBNP, race and endothelial function in the Multi-Ethnic Study of Atherosclerosis. In: Heart. 2019.
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abstract = "Objective: Natriuretic peptides (NPs) are hormones with cardioprotective effects. NP levels vary by race; however, the pathophysiological consequences of lower NP levels are not well understood. We aimed to quantify the association between NPs and endothelial function as measured by flow-mediated dilation (FMD) and the contribution of NP levels to racial differences in endothelial function. Methods: In this cross-sectional study of 2938 Multi-Ethnic Study of Atherosclerosis participants (34{\%} Caucasian, 20{\%} African-American, 20{\%} Asian-American and 26{\%} Hispanic) without cardiovascular disease at baseline, multivariable linear regression models were used to examine the association between serum N-terminal pro-B-type NP (NT-proBNP) and natural log-transformed FMD. We also tested whether NT-proBNP mediated the relationship between race and FMD using the product of coefficients method. Results: Among African-American and Chinese-American individuals, lower NT-proBNP levels were associated with lower FMD, β=0.06 (95{\%} CI: 0.03 to 0.09; p<0.001) and β=0.06 (95{\%} CI: 0.02 to 0.09; p=0.002), respectively. Non-significant associations between NT-proBNP and FMD were found in Hispanic and Caucasian individuals. In multivariable models, endothelial function differed by race, with African-American individuals having the lowest FMD compared with Caucasians, p<0.001. Racial differences in FMD among African-Americans and Chinese-Americans were mediated in part by NT-proBNP levels (African-Americans, mediation effect: -0.03(95{\%} CI: -0.05 to -0.01); Chinese-Americans, mediation effect: -0.03(95{\%} CI: -0.05 to -0.01)). Conclusions: Lower NP levels are associated with worse endothelial function among African-Americans and Chinese-Americans. A relative NP deficiency in some racial/ethnic groups may contribute to differences in vascular function.",
keywords = "cardiac risk factors and prevention, epidemiology",
author = "Sushan Yang and Shi Huang and Daniels, {Lori B.} and Joseph Yeboah and Lima, {Joao A.C.} and Valentina Cannone and Burnett, {John C Jr.} and Beckman, {Joshua A.} and Carr, {J. Jeffrey} and Wang, {Thomas J.} and Gupta, {Deepak K.}",
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T1 - NT-proBNP, race and endothelial function in the Multi-Ethnic Study of Atherosclerosis

AU - Yang, Sushan

AU - Huang, Shi

AU - Daniels, Lori B.

AU - Yeboah, Joseph

AU - Lima, Joao A.C.

AU - Cannone, Valentina

AU - Burnett, John C Jr.

AU - Beckman, Joshua A.

AU - Carr, J. Jeffrey

AU - Wang, Thomas J.

AU - Gupta, Deepak K.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: Natriuretic peptides (NPs) are hormones with cardioprotective effects. NP levels vary by race; however, the pathophysiological consequences of lower NP levels are not well understood. We aimed to quantify the association between NPs and endothelial function as measured by flow-mediated dilation (FMD) and the contribution of NP levels to racial differences in endothelial function. Methods: In this cross-sectional study of 2938 Multi-Ethnic Study of Atherosclerosis participants (34% Caucasian, 20% African-American, 20% Asian-American and 26% Hispanic) without cardiovascular disease at baseline, multivariable linear regression models were used to examine the association between serum N-terminal pro-B-type NP (NT-proBNP) and natural log-transformed FMD. We also tested whether NT-proBNP mediated the relationship between race and FMD using the product of coefficients method. Results: Among African-American and Chinese-American individuals, lower NT-proBNP levels were associated with lower FMD, β=0.06 (95% CI: 0.03 to 0.09; p<0.001) and β=0.06 (95% CI: 0.02 to 0.09; p=0.002), respectively. Non-significant associations between NT-proBNP and FMD were found in Hispanic and Caucasian individuals. In multivariable models, endothelial function differed by race, with African-American individuals having the lowest FMD compared with Caucasians, p<0.001. Racial differences in FMD among African-Americans and Chinese-Americans were mediated in part by NT-proBNP levels (African-Americans, mediation effect: -0.03(95% CI: -0.05 to -0.01); Chinese-Americans, mediation effect: -0.03(95% CI: -0.05 to -0.01)). Conclusions: Lower NP levels are associated with worse endothelial function among African-Americans and Chinese-Americans. A relative NP deficiency in some racial/ethnic groups may contribute to differences in vascular function.

AB - Objective: Natriuretic peptides (NPs) are hormones with cardioprotective effects. NP levels vary by race; however, the pathophysiological consequences of lower NP levels are not well understood. We aimed to quantify the association between NPs and endothelial function as measured by flow-mediated dilation (FMD) and the contribution of NP levels to racial differences in endothelial function. Methods: In this cross-sectional study of 2938 Multi-Ethnic Study of Atherosclerosis participants (34% Caucasian, 20% African-American, 20% Asian-American and 26% Hispanic) without cardiovascular disease at baseline, multivariable linear regression models were used to examine the association between serum N-terminal pro-B-type NP (NT-proBNP) and natural log-transformed FMD. We also tested whether NT-proBNP mediated the relationship between race and FMD using the product of coefficients method. Results: Among African-American and Chinese-American individuals, lower NT-proBNP levels were associated with lower FMD, β=0.06 (95% CI: 0.03 to 0.09; p<0.001) and β=0.06 (95% CI: 0.02 to 0.09; p=0.002), respectively. Non-significant associations between NT-proBNP and FMD were found in Hispanic and Caucasian individuals. In multivariable models, endothelial function differed by race, with African-American individuals having the lowest FMD compared with Caucasians, p<0.001. Racial differences in FMD among African-Americans and Chinese-Americans were mediated in part by NT-proBNP levels (African-Americans, mediation effect: -0.03(95% CI: -0.05 to -0.01); Chinese-Americans, mediation effect: -0.03(95% CI: -0.05 to -0.01)). Conclusions: Lower NP levels are associated with worse endothelial function among African-Americans and Chinese-Americans. A relative NP deficiency in some racial/ethnic groups may contribute to differences in vascular function.

KW - cardiac risk factors and prevention

KW - epidemiology

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JF - Heart

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