Plasma NT‐proBNP concentration is related to ambulatory pulse pressure in peripheral arterial disease

Abstract

Background. Increased levels of N‐terminal prohormone brain natriuretic peptide (NT‐proBNP) are associated with left ventricular dysfunction (LVD) and left ventricular hypertrophy (LVH), but the relation of NT‐proBNP to ambulatory blood pressure (ABP) and hypertensive target organ damage in high‐risk patients with peripheral arterial disease (PAD) has not been studied. We hypothesized that NT‐proBNP levels were increased in patients with PAD in comparison to a matched control group and that levels of NT‐proBNP were related to ABP. Methods. Blood samples were analysed for NT‐proBNP in 103 males with PAD and 96 age‐ and sex‐matched controls. Ninety‐eight PAD patients performed ABP monitoring and 99 underwent Tc‐99m Sestamibi myocardial perfusion SPECT. Results. NT‐proBNP was significantly increased in PAD patients compared with controls [median (interquartiles)] 167(76, 418) vs 68(38, 142) pg/ml, p<0.001. Plasma levels of NT‐proBNP correlated positively to systolic blood pressure (SBP), pulse pressure (PP), night–day ratio of SBP and showed the strongest correlation to average night PP (r = 0.42, p<0.001). In multiple regression analysis, night PP remained independently related to NT‐proBNP. Conclusion. NT‐proBNP levels are markedly increased in PAD patients compared to age‐matched controls. Night PP is related to NT‐proBNP levels independently of other variables highlighting the importance of ambulatory PP as a cardiovascular risk factor. Measurement of NT‐proBNP could be indicated in PAD patients for further risk stratification.