Relation of Plasma Midregional Proatrial Natriuretic Peptide to Target Organ Damage in Adults With Systemic Hypertension

Mahyar Khaleghi, Malik A. Al-Omari, Venkateswarlu Kondragunta, Nils G. Morgenthaler, Joachim Struck, Andreas Bergmann, Thomas H. Mosley, Iftikhar J. Kullo

Research output: Contribution to journalArticlepeer-review

13 Scopus citations

Abstract

We tested the hypothesis that, in adults with essential hypertension, plasma levels of midregional proatrial natriuretic peptide (MR-proANP) are associated with target organ damage. MR-proANP is a newly described stable fragment of N-terminal proatrial natriuretic peptide. Participants included 1,919 adults with hypertension identified from the community (1,037 African-Americans, 65 ± 9 years of age, 72% women; 882 non-Hispanic whites, 61 ± 9 years of age, 55% women). We measured MR-proANP by an immunoluminometric assay. Measurements of target organ damage included the ankle-brachial index (ABI), urinary albumin-creatinine ratio (UACR), and left ventricular (LV) mass (available only in African-Americans). Generalized estimating equations were used to assess whether plasma MR-proANP was associated with measurements of target organ damage, independent of potential confounding variables. In African-Americans, higher MR-proANP was significantly associated with lower ABI (p <0.0001), higher UACR (p <0.0001), and greater LV mass (indexed to height to the power of 2.7, p <0.0001). After adjustment for age, gender, body mass index, systolic blood pressure, estimated glomerular filtration rate, smoking history, diabetes mellitus, total and high-density lipoprotein cholesterols, medication (blood pressure lowering, statin, and aspirin) use, and previous myocardial infarction or stroke, higher MR-proANP levels remained significantly associated with lower ABI (p = 0.01), higher UACR (p = 0.0007), and greater LV mass index (p <0.0001). In non-Hispanic whites, higher MR-proANP levels were significantly associated with lower ABI (p = 0.002) and greater UACR (p = 0.001), but not after adjustment for the covariates listed earlier. In conclusion, plasma MR-proANP may be a marker of target organ damage in the setting of hypertension, especially in African-Americans.

Original languageEnglish (US)
Pages (from-to)1255-1260
Number of pages6
JournalAmerican Journal of Cardiology
Volume103
Issue number9
DOIs
StatePublished - May 1 2009

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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