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N-Terminal Pro-Brain Natriuretic Peptide and Heart Failure Risk Among Individuals With and Without Obesity The Atherosclerosis Risk in Communities (ARIC) Study
Journal article   Open access   Peer reviewed

N-Terminal Pro-Brain Natriuretic Peptide and Heart Failure Risk Among Individuals With and Without Obesity The Atherosclerosis Risk in Communities (ARIC) Study

Chiadi E. Ndumele, Kunihiro Matsushita, Yingying Sang, Mariana Lazo, Sunil K. Agarwal, Vijay Nambi, Anita Deswal, Roger S. Blumenthal, Christie M. Ballantyne, Josef Coresh, …
Circulation (New York, N.Y.), v 133(7), pp 631-638
16 Feb 2016
DOI: https://doi.org/10.1161/CIRCULATIONAHA.115.017298
PMID: 26746175
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1161/CIRCULATIONAHA.115.017298View
Published, Version of Record (VoR) Open

Abstract

Cardiac & Cardiovascular Systems Cardiovascular System & Cardiology Life Sciences & Biomedicine Peripheral Vascular Disease Science & Technology
Background- Obesity is a risk factor for heart failure (HF) but is associated with lower N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. It is unclear whether the prognostic value and implications of NT-proBNP levels for HF risk differ across body mass index (BMI) categories. Methods and Results- We followed up 12 230 ARIC participants free of prior HF at baseline (visit 2, 1990-1992) with BMI >= 18.5 kg/m(2). We quantified and compared the relative and absolute risk associations of NT-proBNP with incident HF across BMI categories. There were 1861 HF events during a median 20.6 years of follow-up. Despite increased HF risk in obesity, a weak inverse association was seen between baseline BMI and NT-proBNP levels (r=-0.10). Nevertheless, higher baseline NT-proBNP was associated with increased HF risk in all BMI categories. NT-proBNP improved HF risk prediction overall, even among those with severe obesity (BMI >= 35 kg/m(2); improvement in C statistic, 0.032; 95% confidence interval, 0.011-0.053). However, given the higher HF rates among those with obesity, at each NT-proBNP level, higher BMI was associated with greater absolute HF risk. Indeed, among those with NT-proBNP of 100 to < 200 pg/mL, the average 10-year HF risk was < 5% among normal-weight individuals but > 10% among the severely obese. Conclusions- Despite its inverse relationship with BMI, NT-proBNP provides significant prognostic information on the risk of developing HF even among individuals with obesity. Given the higher baseline HF risk among persons with obesity, even slight elevations in NT-proBNP may have implications for increased absolute HF risk in this population.

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94 citations in Web of Science
102 citations in Scopus

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UN Sustainable Development Goals (SDGs)

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
Peripheral Vascular Disease
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