Pusuroglu H.,Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center Training and Research Hospital |
Erturk M.,Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center Training and Research Hospital |
Akgul O.,Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center Training and Research Hospital |
Surgit O.,Mehmet Akif Ersoy Thoracic and Cardiovascular Surgery Center Training and Research Hospital |
And 8 more authors.
Experimental and Clinical Cardiology | Year: 2014
Objectives: The N-amino-terminal fragment of the prohormone B-type natriuretic peptide (NT-proBNP) serves as a sensitive marker of left ventricular hypertrophy and volume expansion. It has been demonstrated that hypervolemia, an increase in sympathetic function, may contribute to the occurrence of the non-dipping pattern. In addition, both higher NT-proBNP levels and non-dipper hypertension have been shown to predict cardiovascular events and mortality in the general population. Thus, we investigated whether NT-proBNP could be used to detect non-dipping pattern in hypertensive patients. Methods: We enrolled 309 hypertensive patients with no cardiovascular disease or renal failure (mean age 49.9 ± 10.8 years, 50.6% men). The ambulatory blood pressure (ABP) of all the patients was measured, and the patients were divided into two groups according to ABP: non-dipper hypertensive group (n=174) and dipper hypertensive group (n=135). Results: NT-proBNP values were higher in the non-dipper hypertensive group (81.5± 94 pg/ml) than in the dipper hypertensive group (48.7±66 pg/ml) (p<0.001). In a logistic multivariate analysis, the NT-proBNP value was found to be an independent predictor of nondipping pattern development (odds ratio: 1.022; 95% confidence interval (CI): 1.007-1.038; p<0.05). In a receiver operating characteristic (ROC) curve analysis, a BNP value of 38.5 pg/ml was identified as an effective cutoff point for non-dipper hypertension (area under curve=0.663; 95% CI: 0.64-0.721; p<0.001). An NT-proBNP value >38.5 pg/mL yielded a sensitivity of 61.6% and a specificity of 60% for non-dipper hypertension. There was a correlation between NT-proBNP and systolic blood pressure (especially at night) and age (r=0.233, p<0.001 and r=0.339, p<0.001). There was no correlation between NT-proBNP and diastolic blood pressure, except night diastolic blood pressure (r=0.130, p<0.019). Conclusion: We were able to identify non-dipper patterns using NT-proBNP levels in hypertensive patients without clinical cardiovascular disease or renal failure in clinical practice.