NT-proBNP, race and endothelial function in the Multi-Ethnic Study of Atherosclerosis

Sushan Yang, Shi Huang, Lori B. Daniels, Joseph Yeboah, Joao Lima, Valentina Cannone, John C. Burnett, Joshua A. Beckman, J. Jeffrey Carr, Thomas J. Wang, Deepak K. Gupta

Research output: Contribution to journalArticle

Abstract

Objective: Natriuretic peptides (NPs) are hormones with cardioprotective effects. NP levels vary by race; however, the pathophysiological consequences of lower NP levels are not well understood. We aimed to quantify the association between NPs and endothelial function as measured by flow-mediated dilation (FMD) and the contribution of NP levels to racial differences in endothelial function. Methods: In this cross-sectional study of 2938 Multi-Ethnic Study of Atherosclerosis participants (34% Caucasian, 20% African-American, 20% Asian-American and 26% Hispanic) without cardiovascular disease at baseline, multivariable linear regression models were used to examine the association between serum N-terminal pro-B-type NP (NT-proBNP) and natural log-transformed FMD. We also tested whether NT-proBNP mediated the relationship between race and FMD using the product of coefficients method. Results: Among African-American and Chinese-American individuals, lower NT-proBNP levels were associated with lower FMD, β=0.06 (95% CI: 0.03 to 0.09; p<0.001) and β=0.06 (95% CI: 0.02 to 0.09; p=0.002), respectively. Non-significant associations between NT-proBNP and FMD were found in Hispanic and Caucasian individuals. In multivariable models, endothelial function differed by race, with African-American individuals having the lowest FMD compared with Caucasians, p<0.001. Racial differences in FMD among African-Americans and Chinese-Americans were mediated in part by NT-proBNP levels (African-Americans, mediation effect: -0.03(95% CI: -0.05 to -0.01); Chinese-Americans, mediation effect: -0.03(95% CI: -0.05 to -0.01)). Conclusions: Lower NP levels are associated with worse endothelial function among African-Americans and Chinese-Americans. A relative NP deficiency in some racial/ethnic groups may contribute to differences in vascular function.

Original languageEnglish (US)
JournalHeart
DOIs
StatePublished - Jan 1 2019

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Natriuretic Peptides
Dilatation
Asian Americans
Atherosclerosis
African Americans
Hispanic Americans
Linear Models
Ethnic Groups
Blood Vessels
Cardiovascular Diseases
Cross-Sectional Studies
Serum

Keywords

  • cardiac risk factors and prevention
  • epidemiology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

NT-proBNP, race and endothelial function in the Multi-Ethnic Study of Atherosclerosis. / Yang, Sushan; Huang, Shi; Daniels, Lori B.; Yeboah, Joseph; Lima, Joao; Cannone, Valentina; Burnett, John C.; Beckman, Joshua A.; Carr, J. Jeffrey; Wang, Thomas J.; Gupta, Deepak K.

In: Heart, 01.01.2019.

Research output: Contribution to journalArticle

Yang, S, Huang, S, Daniels, LB, Yeboah, J, Lima, J, Cannone, V, Burnett, JC, Beckman, JA, Carr, JJ, Wang, TJ & Gupta, DK 2019, 'NT-proBNP, race and endothelial function in the Multi-Ethnic Study of Atherosclerosis', Heart. https://doi.org/10.1136/heartjnl-2019-314707
Yang, Sushan ; Huang, Shi ; Daniels, Lori B. ; Yeboah, Joseph ; Lima, Joao ; Cannone, Valentina ; Burnett, John C. ; Beckman, Joshua A. ; Carr, J. Jeffrey ; Wang, Thomas J. ; Gupta, Deepak K. / NT-proBNP, race and endothelial function in the Multi-Ethnic Study of Atherosclerosis. In: Heart. 2019.
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abstract = "Objective: Natriuretic peptides (NPs) are hormones with cardioprotective effects. NP levels vary by race; however, the pathophysiological consequences of lower NP levels are not well understood. We aimed to quantify the association between NPs and endothelial function as measured by flow-mediated dilation (FMD) and the contribution of NP levels to racial differences in endothelial function. Methods: In this cross-sectional study of 2938 Multi-Ethnic Study of Atherosclerosis participants (34{\%} Caucasian, 20{\%} African-American, 20{\%} Asian-American and 26{\%} Hispanic) without cardiovascular disease at baseline, multivariable linear regression models were used to examine the association between serum N-terminal pro-B-type NP (NT-proBNP) and natural log-transformed FMD. We also tested whether NT-proBNP mediated the relationship between race and FMD using the product of coefficients method. Results: Among African-American and Chinese-American individuals, lower NT-proBNP levels were associated with lower FMD, β=0.06 (95{\%} CI: 0.03 to 0.09; p<0.001) and β=0.06 (95{\%} CI: 0.02 to 0.09; p=0.002), respectively. Non-significant associations between NT-proBNP and FMD were found in Hispanic and Caucasian individuals. In multivariable models, endothelial function differed by race, with African-American individuals having the lowest FMD compared with Caucasians, p<0.001. Racial differences in FMD among African-Americans and Chinese-Americans were mediated in part by NT-proBNP levels (African-Americans, mediation effect: -0.03(95{\%} CI: -0.05 to -0.01); Chinese-Americans, mediation effect: -0.03(95{\%} CI: -0.05 to -0.01)). Conclusions: Lower NP levels are associated with worse endothelial function among African-Americans and Chinese-Americans. A relative NP deficiency in some racial/ethnic groups may contribute to differences in vascular function.",
keywords = "cardiac risk factors and prevention, epidemiology",
author = "Sushan Yang and Shi Huang and Daniels, {Lori B.} and Joseph Yeboah and Joao Lima and Valentina Cannone and Burnett, {John C.} and Beckman, {Joshua A.} and Carr, {J. Jeffrey} and Wang, {Thomas J.} and Gupta, {Deepak K.}",
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T1 - NT-proBNP, race and endothelial function in the Multi-Ethnic Study of Atherosclerosis

AU - Yang, Sushan

AU - Huang, Shi

AU - Daniels, Lori B.

AU - Yeboah, Joseph

AU - Lima, Joao

AU - Cannone, Valentina

AU - Burnett, John C.

AU - Beckman, Joshua A.

AU - Carr, J. Jeffrey

AU - Wang, Thomas J.

AU - Gupta, Deepak K.

PY - 2019/1/1

Y1 - 2019/1/1

N2 - Objective: Natriuretic peptides (NPs) are hormones with cardioprotective effects. NP levels vary by race; however, the pathophysiological consequences of lower NP levels are not well understood. We aimed to quantify the association between NPs and endothelial function as measured by flow-mediated dilation (FMD) and the contribution of NP levels to racial differences in endothelial function. Methods: In this cross-sectional study of 2938 Multi-Ethnic Study of Atherosclerosis participants (34% Caucasian, 20% African-American, 20% Asian-American and 26% Hispanic) without cardiovascular disease at baseline, multivariable linear regression models were used to examine the association between serum N-terminal pro-B-type NP (NT-proBNP) and natural log-transformed FMD. We also tested whether NT-proBNP mediated the relationship between race and FMD using the product of coefficients method. Results: Among African-American and Chinese-American individuals, lower NT-proBNP levels were associated with lower FMD, β=0.06 (95% CI: 0.03 to 0.09; p<0.001) and β=0.06 (95% CI: 0.02 to 0.09; p=0.002), respectively. Non-significant associations between NT-proBNP and FMD were found in Hispanic and Caucasian individuals. In multivariable models, endothelial function differed by race, with African-American individuals having the lowest FMD compared with Caucasians, p<0.001. Racial differences in FMD among African-Americans and Chinese-Americans were mediated in part by NT-proBNP levels (African-Americans, mediation effect: -0.03(95% CI: -0.05 to -0.01); Chinese-Americans, mediation effect: -0.03(95% CI: -0.05 to -0.01)). Conclusions: Lower NP levels are associated with worse endothelial function among African-Americans and Chinese-Americans. A relative NP deficiency in some racial/ethnic groups may contribute to differences in vascular function.

AB - Objective: Natriuretic peptides (NPs) are hormones with cardioprotective effects. NP levels vary by race; however, the pathophysiological consequences of lower NP levels are not well understood. We aimed to quantify the association between NPs and endothelial function as measured by flow-mediated dilation (FMD) and the contribution of NP levels to racial differences in endothelial function. Methods: In this cross-sectional study of 2938 Multi-Ethnic Study of Atherosclerosis participants (34% Caucasian, 20% African-American, 20% Asian-American and 26% Hispanic) without cardiovascular disease at baseline, multivariable linear regression models were used to examine the association between serum N-terminal pro-B-type NP (NT-proBNP) and natural log-transformed FMD. We also tested whether NT-proBNP mediated the relationship between race and FMD using the product of coefficients method. Results: Among African-American and Chinese-American individuals, lower NT-proBNP levels were associated with lower FMD, β=0.06 (95% CI: 0.03 to 0.09; p<0.001) and β=0.06 (95% CI: 0.02 to 0.09; p=0.002), respectively. Non-significant associations between NT-proBNP and FMD were found in Hispanic and Caucasian individuals. In multivariable models, endothelial function differed by race, with African-American individuals having the lowest FMD compared with Caucasians, p<0.001. Racial differences in FMD among African-Americans and Chinese-Americans were mediated in part by NT-proBNP levels (African-Americans, mediation effect: -0.03(95% CI: -0.05 to -0.01); Chinese-Americans, mediation effect: -0.03(95% CI: -0.05 to -0.01)). Conclusions: Lower NP levels are associated with worse endothelial function among African-Americans and Chinese-Americans. A relative NP deficiency in some racial/ethnic groups may contribute to differences in vascular function.

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KW - epidemiology

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