DETERMINANTS OF N-TERMINAL PRO ATRIAL NATRIURETIC PEPTIDE PLASMA LEVELS IN A SURVEY OF ADULT MALE POPULATION FROM SOUTHERN ITALY: PP.12.450

Abstract

Objective: Natriuretic peptides (NP) control cardiovascular functions through diuretic, natriuretic, vasodilatory properties. Several anthropometric, cardiac and renal parameters were found to be independently correlated to their levels. Few studies, however, systematically investigated the independent determinants of NP levels in large populations. Design and Method: The present analysis was carried out in a large unselected sample of adult male population in Southern Italy (The Olivetti Heart Study, n = 806 men, mean age = 59.5, range 35–82 years). We examined: a) the relationship of plasma NT-proANP levels with relevant anthropometric, clinical and biochemical variables; b) the impact of age; c) the association of NT-proANP levels with cardiovascular risk. Results: NT-proANP was directly associated to age, pulse pressure (PP), renal sodium fractional excretion (FENa) (p < 0.005), and inversely to diastolic blood pressure (DBP), heart rate (HR), creatinine clearance (CC), body mass index (BMI), arm and leg circumferences (p < 0.005). After adjustment for age, DBP, CC, FENa and HR remained independent determinants of NT-proANP levels (all p < 0.01, cumulative R2 = 0.186). Upon stratification of our population by tertile of age, NT-proANP was significantly (p ≤ 0.01) associated to arm circumference in the lowest age tertile (mean age: 53.8 yrs), and to FENa, DBP, HR, CC and HOMA index in the highest tertile (mean age: 66.7 yrs). There was a direct association between NT-proANP levels and cardiovascular risk score in the whole cohort as estimated by the Progetto Cuore algorithm. Conclusions: Anthropometric, cardiovascular and renal factors exerted a substantially different impact on NT-proANP levels at different ages. Higher NT-proANP levels correlated to increased cardiovascular risk in our study sample.