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N-terminal brain na...
N-terminal brain natriuretic peptide predicted cardiovascular events stronger than high-sensitivity C-reactive protein in hypertension: a LIFE substudy
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Olsen, M. H. (författare)
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Wachtell, K. (författare)
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Nielsen, O. W. (författare)
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Hall, C. (författare)
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Wergeland, R. (författare)
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Ibsen, H. (författare)
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Kjeldsen, S. E. (författare)
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Devereux, R. B. (författare)
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- Dahlöf, Björn, 1953 (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för akut och kardiovaskulär medicin,Institute of Medicine, Department of Emergeny and Cardiovascular Medicine
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Hildebrandt, P. R. (författare)
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(creator_code:org_t)
- 2006
- 2006
- Engelska.
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Ingår i: J Hypertens. - 0263-6352. ; 24:8, s. 1531-9
- Relaterad länk:
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https://gup.ub.gu.se...
Abstract
Ämnesord
Stäng
- BACKGROUND: N-terminal pro-brain natriuretic peptide (Nt-proBNP) and high-sensitivity C-reactive protein (hsCRP) are cardiovascular risk markers in various populations, but are not well examined in hypertension. Therefore, we wanted to investigate whether high Nt-proBNP or hsCRP predicted the composite endpoint of cardiovascular death, non-fatal stroke or non-fatal myocardial infarction independently of traditional cardiovascular risk factors and the urine albumin: creatinine ratio (UACR), which is a well established cardiovascular risk factor in hypertension. METHODS: In 945 hypertensive patients from the LIFE study with electrocardiographic left ventricular (LV) hypertrophy, we measured traditional cardiovascular risk factors including electrocardiography, morning UACR, hsCRP by immunoturbidimetry assay and Nt-proBNP by immunoassay after 2 weeks of placebo treatment. During 55 months' follow-up 80 patients suffered a composite endpoint. RESULTS: HsCRP as well as Nt-proBNP above the median values of 3.0 mg/l and 170 pg/ml, respectively, was associated with a higher incidence of composite endpoint (13.1 versus 3.8%, P < 0.01, and 11.5 versus 5.4%, P < 0.01). In Cox regression analyses, standardized log(hsCRP)/SD predicted a composite endpoint [hazard ratio (HR) 1.3 per SD = 0.47 log(mg/l), P < 0.05] after adjustment for traditional cardiovascular risk factors, but not after further adjustment for UACR. Standardized log(Nt-proBNP)/SD predicted a composite endpoint after adjustment for traditional cardiovascular risk factors [HR 1.9 per SD = 0.49 log(pg/ml), P < 0.05] as well as after further adjustment for UACR [HR 1.5 per SD = 0.49 log(pg/ml), P < 0.01]. Log(Nt-proBNP) added significantly to the Cox regression models using traditional cardiovascular risk factors with and without UACR (both P < 0.001). CONCLUSION: Nt-proBNP predicted a composite endpoint after adjustment for traditional risk factors, UACR and a history of diabetes or cardiovascular disease and added significantly to the prediction of composite endpoint, whereas hsCRP did not.
Nyckelord
- Aged
- Aged
- 80 and over
- Albumins/metabolism
- Antihypertensive Agents/*therapeutic use
- Atenolol/therapeutic use
- Biological Markers/blood/urine
- C-Reactive Protein/*metabolism
- Cardiovascular Diseases/epidemiology/metabolism
- Confounding Factors (Epidemiology)
- Creatinine/urine
- Endpoint Determination
- Female
- Follow-Up Studies
- Humans
- Hypertension/blood/*drug therapy/epidemiology/*metabolism/urine
- Hypertrophy
- Left Ventricular/drug therapy/metabolism
- Losartan/therapeutic use
- Male
- Middle Aged
- Natriuretic Peptide
- Brain/*blood
- Peptide Fragments/*blood
- Predictive Value of Tests
- Proportional Hazards Models
- ROC Curve
- Risk Factors
- Scandinavia/epidemiology
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Olsen, M. H.
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Wachtell, K.
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Nielsen, O. W.
-
Hall, C.
-
Wergeland, R.
-
Ibsen, H.
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visa fler...
-
Kjeldsen, S. E.
-
Devereux, R. B.
-
Dahlöf, Björn, 1 ...
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Hildebrandt, P. ...
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visa färre...
- Artiklar i publikationen
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J Hypertens
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Göteborgs universitet