The relationship between N‑ terminal pro B‑ type natriuretic peptide and indicators of daily monitoring of blood pressure in middle-aged hypertensive men with chronic heart failure

Abstract

Objective. To study the association between N‑terminal pro B‑type natriuretic peptide (NT-proBNP) and diurnal blood pressure (BP) profile in middle-aged men with arterial hypertension (HTN) and chronic heart failure (CHF). Design and methods. We surveyed 550 men from 40 to 50 years, 420 subjects were included in the study and were divided into groups: 1st group — patients with HTN without CHF (n = 180); 2nd group — patients with HTN and CHF (n = 86); 3rd group — patients with CHF without HTN (n = 74). The control group consisted of healthy men with normal BP without CHF (n = 80). NT-proBNP (fmol/ml) and 24‑hour BP monitoring were performed in all patients. Results. NT-proBNP was lower in patients with HTN 2 and 3 degree in comparison with patients with HTN 1 degree without CHF (group 1). It was not found in hypertensive patients with CHF (group 2). NT-proBNP was higher in patients with HTN 1 degree in the 1st group in comparison with patients with HTN 1 degree in the second group and lower in patients with HTN 2 and 3 degree in the first group, in comparison with patients with HTN 2 and 3 degree in the 2nd group. There was an inverse correlation between NT-proBNP and HTN degree in the 1st group (r = –0,624; p = 0,023). Conclusions . The decrease in plasma level of NT-proBNP in hypertensive patients is associated with the increase in BP. Natriuretic peptides are involved in the circadian rhythm of BP, and their level is associated with the HTN degree and «load pressure». NT-proBNP was the highest in «non-dippers» and «night-peakers» and differed significantly from «over-dippers» and patients with unchanged circadian BP profile.