The role of NT-proBNP in screening for atrial fibrillation in hypertensive disease
Background: Atrial fibrillation (AF) screening should be considered in elderly patients with high risk of stroke, which include individuals with hypertension. The biomarker N-terminal prohormone of brain natriuretic peptide (NT-proBNP) can predict incident AF and is increased in hypertensive individ...
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Elsevier
2024-12-01
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| Series: | International Journal of Cardiology: Heart & Vasculature |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S235290672400215X |
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| author | Gina Sado Katrin Kemp Gudmundsdottir Carl Bonander Mattias Ekström Johan Engdahl Emma Svennberg |
| author_facet | Gina Sado Katrin Kemp Gudmundsdottir Carl Bonander Mattias Ekström Johan Engdahl Emma Svennberg |
| author_sort | Gina Sado |
| collection | DOAJ |
| description | Background: Atrial fibrillation (AF) screening should be considered in elderly patients with high risk of stroke, which include individuals with hypertension. The biomarker N-terminal prohormone of brain natriuretic peptide (NT-proBNP) can predict incident AF and is increased in hypertensive individuals. The aim of this study is to investigate the incidence of screening-detected AF in elderly individuals in relation to NT-proBNP and hypertension. Methods: STROKESTOP II is a randomized controlled trial in which 75/76-years-old individuals were invited to a screening study for AF using NT-proBNP as a discriminator of high risk. In this sub-study, a prior hypertension diagnosis was self-reported by participants and measured blood pressure was stratified into hypertension-grades. Individuals with both increased blood pressure (≥140 mmHg) and NT-proBNP ≥ 125 ng/L were defined as a high-risk group. The lowest risk-group was defined as normotensive participants with NT-proBNP < 125 ng/L. Results: NT-proBNP increased gradually for every hypertension-grade above hypertension-grade 1 compared to normotensive participants. Screening-detected AF was most common in normotensive participants with increased NT-proBNP (n = 90/1922, 4.7 %), followed by patients with both NT-proBNP > 125 ng/l and SBP ≥ 140 mmHg, (AF = 65/1741, 3.7 %) compared to the low-risk group (AF = 2/1444, 0.1 %), p < 0.001. Conclusion: NT-proBNP is elevated in elderly patients with hypertension and increases with grades of hypertensive disease. NT-proBNP is a strong predictor of AF regardless of high blood pressure, and the risk for screening-detected AF is very low in participants with normal blood pressure and low NT-proBNP. A combination of blood pressure and NT-proBNP could identify suitable participants for AF screening. |
| format | Article |
| id | doaj-art-2b3f427d8f824657850e0e3096c8f379 |
| institution | Kabale University |
| issn | 2352-9067 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Elsevier |
| record_format | Article |
| series | International Journal of Cardiology: Heart & Vasculature |
| spelling | doaj-art-2b3f427d8f824657850e0e3096c8f3792024-11-29T06:24:27ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672024-12-0155101549The role of NT-proBNP in screening for atrial fibrillation in hypertensive diseaseGina Sado0Katrin Kemp Gudmundsdottir1Carl Bonander2Mattias Ekström3Johan Engdahl4Emma Svennberg5Karolinska Institutet, Department of Medicine, Karolinska University Hospital Huddinge, Sweden; Department of Cardiology, Danderyd University Hospital, Stockholm, Sweden; Corresponding author at: Department of Cardiology, Danderyd University Hospital, SE-182 88 Stockholm, Sweden.Karolinska Institutet, Department of Clinical Sciences – Danderyd University Hospital, SwedenSchool of Public Health and Community Medicine, Institute of Medicine, University of Gothenburg, SwedenKarolinska Institutet, Department of Clinical Sciences – Danderyd University Hospital, Sweden; Department of Cardiology, Danderyd University Hospital, Stockholm, SwedenKarolinska Institutet, Department of Clinical Sciences – Danderyd University Hospital, Sweden; Department of Cardiology, Danderyd University Hospital, Stockholm, SwedenKarolinska Institutet, Department of Medicine, Karolinska University Hospital Huddinge, SwedenBackground: Atrial fibrillation (AF) screening should be considered in elderly patients with high risk of stroke, which include individuals with hypertension. The biomarker N-terminal prohormone of brain natriuretic peptide (NT-proBNP) can predict incident AF and is increased in hypertensive individuals. The aim of this study is to investigate the incidence of screening-detected AF in elderly individuals in relation to NT-proBNP and hypertension. Methods: STROKESTOP II is a randomized controlled trial in which 75/76-years-old individuals were invited to a screening study for AF using NT-proBNP as a discriminator of high risk. In this sub-study, a prior hypertension diagnosis was self-reported by participants and measured blood pressure was stratified into hypertension-grades. Individuals with both increased blood pressure (≥140 mmHg) and NT-proBNP ≥ 125 ng/L were defined as a high-risk group. The lowest risk-group was defined as normotensive participants with NT-proBNP < 125 ng/L. Results: NT-proBNP increased gradually for every hypertension-grade above hypertension-grade 1 compared to normotensive participants. Screening-detected AF was most common in normotensive participants with increased NT-proBNP (n = 90/1922, 4.7 %), followed by patients with both NT-proBNP > 125 ng/l and SBP ≥ 140 mmHg, (AF = 65/1741, 3.7 %) compared to the low-risk group (AF = 2/1444, 0.1 %), p < 0.001. Conclusion: NT-proBNP is elevated in elderly patients with hypertension and increases with grades of hypertensive disease. NT-proBNP is a strong predictor of AF regardless of high blood pressure, and the risk for screening-detected AF is very low in participants with normal blood pressure and low NT-proBNP. A combination of blood pressure and NT-proBNP could identify suitable participants for AF screening.http://www.sciencedirect.com/science/article/pii/S235290672400215XAtrial fibrillationHypertensionHypertension gradesBlood pressureNT-proBNPMass screening |
| spellingShingle | Gina Sado Katrin Kemp Gudmundsdottir Carl Bonander Mattias Ekström Johan Engdahl Emma Svennberg The role of NT-proBNP in screening for atrial fibrillation in hypertensive disease International Journal of Cardiology: Heart & Vasculature Atrial fibrillation Hypertension Hypertension grades Blood pressure NT-proBNP Mass screening |
| title | The role of NT-proBNP in screening for atrial fibrillation in hypertensive disease |
| title_full | The role of NT-proBNP in screening for atrial fibrillation in hypertensive disease |
| title_fullStr | The role of NT-proBNP in screening for atrial fibrillation in hypertensive disease |
| title_full_unstemmed | The role of NT-proBNP in screening for atrial fibrillation in hypertensive disease |
| title_short | The role of NT-proBNP in screening for atrial fibrillation in hypertensive disease |
| title_sort | role of nt probnp in screening for atrial fibrillation in hypertensive disease |
| topic | Atrial fibrillation Hypertension Hypertension grades Blood pressure NT-proBNP Mass screening |
| url | http://www.sciencedirect.com/science/article/pii/S235290672400215X |
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