N-terminal pro-brain natriuretic peptide (NT-proBNP) and risk of hypertension in the Atherosclerosis Risk in Communities (ARIC) study

Julie K. Bower, Mariana Lazo-Elizondo, Kunihiro Matsushita, Jonathan Rubin, Ron C. Hoogeveen, Christie M. Ballantyne, Elizabeth Selvin

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


BACKGROUND Brain natriuretic peptide (BNP) is released by the heart in response to ventricular and auricular wall stress. Release of BNP is traditionally considered part of the body's protective mechanism against pressure overload by inducing vasodilatation and diuresis. More recent evidence demonstrates that BNP also promotes vessel wall stress and preliminary studies suggest that chronic increased levels may increase risk of hypertension. This study aimed to evaluate the prospective association of N-terminal BNP (NT-proBNP), a cleavage product of BNP, with risk of hypertension in the Atherosclerosis Risk in Communities cohort study. METHODS We conducted a prospective analysis of 3,798 middle-aged participants in the ARIC study without hypertension at baseline (1996-1998). Using Cox proportional hazards models, we characterized the association between NT-proBNP at baseline and newly diagnosed hypertension for a maximum of 14 years of follow-up (median = 9 years). RESULTS We observed 2,113 new hypertension cases over the follow-up period. Higher baseline NT-proBNP was independently associated with an increased risk of hypertension. Adjusted hazard ratios for incident hypertension in the highest quartile compared to the lowest quartile of NT-proBNP at baseline was 1.24 (95% CI: 1.08-1.42). Each log-unit increase in NT-proBNP was associated with an 8% increased risk of hypertension (95% CI: 1.03-1.13). CONCLUSIONS Persons with elevated NT-proBNP, even with normal blood pressure at baseline, were at increased risk of developing hypertension. Our results suggest that elevated circulating BNP might contribute to the development of hypertension in previously normotensive individuals.

Original languageEnglish (US)
Pages (from-to)1262-1266
Number of pages5
JournalAmerican Journal of Hypertension
Issue number10
StatePublished - Oct 2015


  • biological markers
  • blood pressure
  • brain natriuretic peptide
  • cohort
  • epidemiology
  • hypertension
  • risk factors

ASJC Scopus subject areas

  • Internal Medicine


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