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

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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.

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

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Keywords

  • cardiac risk factors and prevention
  • epidemiology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Yang, S., Huang, S., Daniels, L. B., Yeboah, J., Lima, J., Cannone, V., Burnett, J. C., Beckman, J. A., Carr, J. J., Wang, T. J., & Gupta, D. K. (2019). NT-proBNP, race and endothelial function in the Multi-Ethnic Study of Atherosclerosis. Heart. https://doi.org/10.1136/heartjnl-2019-314707