Abstract
OBJECTIVE: To study whether prospective measurements of circulating concentrations of brain natriuretic peptide (BNP) could predict mortality in the general elderly population. DESIGN AND SETTING: Circulating BNP was measured in a cohort of 85 year olds from the general population who were followed up prospectively for five years as part of a longitudinal population study, "70 year old people in Gothenburg, Sweden". PATIENTS: 541 subjects from the 85 year old population in Gothenburg. All subjects were investigated for the presence or absence of cardiovascular disorder such as congestive heart failure, ischaemic heart disease, hypertension, and atrial fibrillation. Venous plasma samples were obtained for BNP analysis. MAIN OUTCOME MEASURE: Overall mortality during the prospective follow up period. RESULTS: Circulating concentrations of BNP predicted five-year mortality in the total population (P < 0.001). In subjects with a known cardiovascular disorder, five-year mortality was correlated with increased BNP concentrations (P < 0.01). Increased BNP concentrations predicted five-year mortality in subjects without a defined cardiovascular disorder (P < 0.05). CONCLUSIONS: In an elderly population, measurements of BNP may add valuable prognostic information and may be used to predict mortality in the total population as well as in patients with known cardiovascular disorders. In subjects without any known cardiovascular disorder, BNP was a strong and independent predictor of total mortality.
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- Arakawa N., Nakamura M., Aoki H., Hiramori K. Relationship between plasma level of brain natriuretic peptide and myocardial infarct size. Cardiology. 1994;85(5):334–340. doi: 10.1159/000176706. [DOI] [PubMed] [Google Scholar]
- Cockcroft D. W., Gault M. H. Prediction of creatinine clearance from serum creatinine. Nephron. 1976;16(1):31–41. doi: 10.1159/000180580. [DOI] [PubMed] [Google Scholar]
- Francis G. S., Benedict C., Johnstone D. E., Kirlin P. C., Nicklas J., Liang C. S., Kubo S. H., Rudin-Toretsky E., Yusuf S. Comparison of neuroendocrine activation in patients with left ventricular dysfunction with and without congestive heart failure. A substudy of the Studies of Left Ventricular Dysfunction (SOLVD). Circulation. 1990 Nov;82(5):1724–1729. doi: 10.1161/01.cir.82.5.1724. [DOI] [PubMed] [Google Scholar]
- Gottlieb S. S., Kukin M. L., Ahern D., Packer M. Prognostic importance of atrial natriuretic peptide in patients with chronic heart failure. J Am Coll Cardiol. 1989 Jun;13(7):1534–1539. doi: 10.1016/0735-1097(89)90344-6. [DOI] [PubMed] [Google Scholar]
- Hall C., Rouleau J. L., Moyè L., de Champlain J., Bichet D., Klein M., Sussex B., Packer M., Rouleau J., Arnold M. O. N-terminal proatrial natriuretic factor. An independent predictor of long-term prognosis after myocardial infarction. Circulation. 1994 May;89(5):1934–1942. doi: 10.1161/01.cir.89.5.1934. [DOI] [PubMed] [Google Scholar]
- Kohno M., Horio T., Yokokawa K., Murakawa K., Yasunari K., Akioka K., Tahara A., Toda I., Takeuchi K., Kurihara N. Brain natriuretic peptide as a cardiac hormone in essential hypertension. Am J Med. 1992 Jan;92(1):29–34. doi: 10.1016/0002-9343(92)90011-y. [DOI] [PubMed] [Google Scholar]
- Landahl S., Svanborg A., Astrand K. Heart volume and the prevalence of certain common cardiovascular disorders at 70 and 75 years of age. Eur Heart J. 1984 Apr;5(4):326–331. doi: 10.1093/oxfordjournals.eurheartj.a061659. [DOI] [PubMed] [Google Scholar]
- Lerman A., Gibbons R. J., Rodeheffer R. J., Bailey K. R., McKinley L. J., Heublein D. M., Burnett J. C., Jr Circulating N-terminal atrial natriuretic peptide as a marker for symptomless left-ventricular dysfunction. Lancet. 1993 May 1;341(8853):1105–1109. doi: 10.1016/0140-6736(93)93125-k. [DOI] [PubMed] [Google Scholar]
- Lernfelt B., Wikstrand J., Svanborg A., Landahl S. Aging and left ventricular function in elderly healthy people. Am J Cardiol. 1991 Aug 15;68(5):547–549. doi: 10.1016/0002-9149(91)90797-o. [DOI] [PubMed] [Google Scholar]
- McGregor A., Richards M., Espiner E., Yandle T., Ikram H. Brain natriuretic peptide administered to man: actions and metabolism. J Clin Endocrinol Metab. 1990 Apr;70(4):1103–1107. doi: 10.1210/jcem-70-4-1103. [DOI] [PubMed] [Google Scholar]
- Mukoyama M., Nakao K., Obata K., Jougasaki M., Yoshimura M., Morita E., Hosoda K., Suga S., Ogawa Y., Yasue H. Augmented secretion of brain natriuretic peptide in acute myocardial infarction. Biochem Biophys Res Commun. 1991 Oct 15;180(1):431–436. doi: 10.1016/s0006-291x(05)81311-7. [DOI] [PubMed] [Google Scholar]
- Mukoyama M., Nakao K., Saito Y., Ogawa Y., Hosoda K., Suga S., Shirakami G., Jougasaki M., Imura H. Increased human brain natriuretic peptide in congestive heart failure. N Engl J Med. 1990 Sep 13;323(11):757–758. doi: 10.1056/NEJM199009133231114. [DOI] [PubMed] [Google Scholar]
- Omland T., Aakvaag A., Bonarjee V. V., Caidahl K., Lie R. T., Nilsen D. W., Sundsfjord J. A., Dickstein K. Plasma brain natriuretic peptide as an indicator of left ventricular systolic function and long-term survival after acute myocardial infarction. Comparison with plasma atrial natriuretic peptide and N-terminal proatrial natriuretic peptide. Circulation. 1996 Jun 1;93(11):1963–1969. doi: 10.1161/01.cir.93.11.1963. [DOI] [PubMed] [Google Scholar]
- Omland T., Aakvaag A., Vik-Mo H. Plasma cardiac natriuretic peptide determination as a screening test for the detection of patients with mild left ventricular impairment. Heart. 1996 Sep;76(3):232–237. doi: 10.1136/hrt.76.3.232. [DOI] [PMC free article] [PubMed] [Google Scholar]
- ROSE G. A. The diagnosis of ischaemic heart pain and intermittent claudication in field surveys. Bull World Health Organ. 1962;27:645–658. [PMC free article] [PubMed] [Google Scholar]
- Rinder L., Roupe S., Steen B., Svanborg A. Seventy-year-old people in Gothenburg. A population study in an industrialized Swedish city. Acta Med Scand. 1975 Nov;198(5):397–407. doi: 10.1111/j.0954-6820.1975.tb19563.x. [DOI] [PubMed] [Google Scholar]
- Sudoh T., Kangawa K., Minamino N., Matsuo H. A new natriuretic peptide in porcine brain. Nature. 1988 Mar 3;332(6159):78–81. doi: 10.1038/332078a0. [DOI] [PubMed] [Google Scholar]
- Wong W. F., Gold S., Fukuyama O., Blanchette P. L. Diastolic dysfunction in elderly patients with congestive heart failure. Am J Cardiol. 1989 Jun 15;63(20):1526–1528. doi: 10.1016/0002-9149(89)90022-2. [DOI] [PubMed] [Google Scholar]
- Yasue H., Yoshimura M., Sumida H., Kikuta K., Kugiyama K., Jougasaki M., Ogawa H., Okumura K., Mukoyama M., Nakao K. Localization and mechanism of secretion of B-type natriuretic peptide in comparison with those of A-type natriuretic peptide in normal subjects and patients with heart failure. Circulation. 1994 Jul;90(1):195–203. doi: 10.1161/01.cir.90.1.195. [DOI] [PubMed] [Google Scholar]