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a Department of
Medicine and Therapeutics, Robert Kilpatrick Clinical Sciences
Building, Leicester Royal Infirmary, Leicester LE2 7LX, UK, b Cardiovascular
Research Institute, University of Leicester, Leicester, UK
Correspondence to: Dr Ng email: LLN1{at}le.ac.uk
Accepted 25 October
1999
OBJECTIVES
To examine the relation between plasma
concentration of the N terminal of the precursor of brain natriuretic
peptide (NT proBNP), left ventricular hypertrophy (LVH), and left
ventricular systolic dysfunction (LVSD) in patients with a history of hypertension.
DESIGNProspective study.
SETTINGTeaching hospital based study.
PATIENTSNT proBNP concentrations were determined in
five groups of individuals. Group 1: 15 echocardiographic normal
controls; group 2: 22 patients with hypertension, normal left
ventricular systolic function, and no LVH; group 3: 24 patients with
hypertension, normal left ventricular systolic function, and LVH; group
4: 13 patients with history of hypertension, no history of ischaemic heart disease, and left ventricular wall motion index (WMI) between 1.9-1.3; and group 5:17 patients with a history of hypertension, no
history of ischaemic heart disease, and WMI < 1.2.
RESULTS Median (range) NT proBNP concentrations (in
fmol/ml) for groups 1-5, respectively, were: 129.4 (53.6-159.7),
147.4 (54.3-730.5), 137.1 (35.8-403.9), 356.7 (124.4-934.4), and
493.5 (248.9-909). Mean log NT proBNP differed among all five groups
(p < 0.0001), and between groups 4 and 5 versus groups 1-3
(p < 0.0001), and group 4 versus group 5 (p = 0.02) only.
CONCLUSIONSThe results suggest that the presence of
hypertension with or without LVH (and normal left ventricular systolic
function) does not affect NT proBNP concentrations. Moreover, there is
a significant rise in NT proBNP only when LVSD develops in
hypertension. Thus, NT proBNP remains a useful diagnostic aid for LVSD,
even in hypertensive patients.
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