Physicians' Academy for Cardiovascular Education

NTproBNP levels differ by race, but association of NTproBNP levels and mortality does not

Racial Differences in Plasma Levels of N-Terminal Pro–B-Type Natriuretic Peptide and Outcomes The Reasons for Geographic and Racial Differences in Stroke (REGARDS) Study

Literature - Bajaj NS, Gutierrez OM, Arora G, et al. - JAMA Cardiol. 2018;3(1):11

Main results

Conclusion

Healthy black adults have significantly lower NTproBNP levels compared with white individuals. This difference between the groups did not modify the association between baseline NTproBNP levels and the risk of all-cause and CV mortality.

Editorial comment

In his editorial article [5], Wang explains the pathophysiological importance of natriuretic peptides as protective cardio-renal and cardio-metabolic hormones, although they are primarily used as biomarker in the clinical setting: ‘Physicians are accustomed to thinking of BNP as a bad thing because elevated BNP is seen in patients with overt heart failure and frequently portends a poor prognosis. Of course, the problem is not the BNP itself, but the condition that causes the BNP to be elevated. Indeed, natriuretic peptide production is an important component of the body’s defense against cardiac overload.’

Moreover, he discusses potential pharmacologic and non-pharmacologic specific therapeutic approaches for individuals with natriuretic peptide deficiency and he concludes: ‘Endocrine therapies are administered to individuals with specific evidence of endocrine dysfunction, not to capture short-term beneficial effects. For instance, thyroid hormone is given only to patients in whom hypothyroidism is demonstrated, not based on its metabolic actions. Studies are warranted to determine whether a similar strategy for the heart’s endocrine system can advance the prevention and treatment of cardiometabolic disease.’

References

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Find this article online at JAMA Cardiol

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