Table 2.
Adjusted Hazard Ratio of Cardiovascular Events Across Systolic Blood Pressure and NT-Pro-BNP Categories, ARIC Study (1996–1998, Visit 4)
| SBP, mmHg | NT-Pro-BNP | P-trend‡ | |||||
|---|---|---|---|---|---|---|---|
| <100 pg/mL | ≥100 to <300 pg/mL | ≥300 pg/mL | |||||
| n/N (event rate*) | HR (95% CI)† | n/N (event rate*) | HR (95% CI)† | n/N (event rate*) | HR (95% CI)† | ||
| Cardiovascular disease (CVD) | |||||||
| < 120 | 466/2602 (11.95) | Ref | 160/761 (14.82) | 1.47 (1.22–1.76) | 44/106 (37.27) | 3.01 (2.19–4.14) | <0.0001 |
| 120–129 | 332/1531 (14.96) | 1.08 (0.93–1.24) | 142/517 (20.21) | 1.56 (1.29–1.89) | 33/84 (34.02) | 2.59 (1.81–3.70) | <0.0001 |
| 130–139 | 288/1073 (19.06) | 1.23 (1.06–1.43) | 138/430 (24.30) | 1.91 (1.57–2.32) | 44/78 (59.84) | 4.15 (3.03–5.69) | <0.0001 |
| 140–149 | 170/611 (20.17) | 1.22 (1.02–1.46) | 113/336 (25.55) | 1.91 (1.54–2.35) | 38/70 (51.63) | 3.35 (2.39–4.70) | <0.0001 |
| ≥ 150 | 172/544 (23.13) | 1.36 (1.13–1.63) | 186/426 (35.73) | 2.49 (2.09–2.97) | 90/140 (72.33) | 4.59 (3.63–5.81) | <0.0001 |
| P trend | 0.002 | 0.0001 | 0.01 | ||||
| Heart failure hospitalization | |||||||
| < 120 | 198/2602 (4.84) | Ref | 107/761 (9.59) | 2.13 (1.68–2.71) | 34/106 (27.18) | 4.89 (3.38–7.09) | <0.0001 |
| 120–129 | 158/1531 (6.76) | 1.12 (0.91–1.39) | 84/517 (11.24) | 1.80 (1.38–2.33) | 23/84 (22.91) | 3.63 (2.34–5.62) | <0.0001 |
| 130–139 | 137/1073 (8.49) | 1.18 (0.94–1.47) | 90/430 (14.91) | 2.38 (1.85–3.08) | 34/78 (42.53) | 6.42 (4.44–9.31) | <0.0001 |
| 140–149 | 87/611 (9.66) | 1.20 (0.93–1.55) | 75/336 (16.07) | 2.40 (1.83–3.16) | 33/70 (42.80) | 5.53 (3.78–8.09) | <0.0001 |
| ≥ 150 | 95/544 (12.11) | 1.39 (1.08–1.79) | 109/426 (19.10) | 2.68 (2.10–3.42) | 64/140 (47.90) | 5.80 (4.32–7.78) | <0.0001 |
| P trend | 0.32 | 0.10 | 0.14 | ||||
| Coronary Heart Disease (CHD) | |||||||
| < 120 | 304/2602 (7.70) | Ref | 72/761 (6.49) | 1.07 (0.82–1.39) | 22/106 (17.46) | 2.08 (1.33–3.25) | 0.03 |
| 120–129 | 199/1531 (8.80) | 1.04 (0.87–1.25) | 81/517 (11.19) | 1.53 (1.19–1.96) | 13/84 (12.20) | 1.65 (0.94–2.89) | 0.01 |
| 130–139 | 172/1073 (11.19) | 1.22 (1.01–1.48) | 67/430 (11.28) | 1.56 (1.19–2.04) | 18/78 (21.78) | 2.26 (1.39–3.66) | 0.03 |
| 140–149 | 94/611 (10.93) | 1.16 (0.91–1.46) | 58/336 (12.62) | 1.74 (1.29–2.30) | 20/70 (25.05) | 2.67 (1.68–4.24) | 0.01 |
| ≥ 150 | 95/544 (12.41) | 1.34 (1.06–1.71) | 106/426 (19.35) | 2.44 (1.93–3.07) | 38/140 (26.84) | 2.90 (2.04–4.12) | <0.0001 |
| P trend | 0.05 | 0.0001 | 0.47 | ||||
| Ischemic stroke | |||||||
| < 120 | 68/2602 (1.64) | Ref | 24/761 (2.10) | 1.42 (0.89–2.28) | 9/106 (6.73) | 3.90 (1.93–7.92) | 0.004 |
| 120–129 | 67/1531 (2.84) | 1.52 (1.08–2.14) | 37/517 (4.81) | 2.58 (1.70–3.90) | 6/84 (5.41) | 2.84 (1.22–6.61) | 0.06 |
| 130–139 | 58/1073 (3.55) | 1.66 (1.16–2.37) | 26/430 (4.16) | 2.25 (1.42–3.57) | 10/78 (11.09) | 5.22 (2.65–10.27) | 0.005 |
| 140–149 | 38/611 (4.17) | 1.79 (1.19–2.68) | 27/336 (5.55) | 2.88 (1.82–4.54) | 8/70 (9.69) | 4.55 (2.15–9.60) | 0.04 |
| ≥ 150 | 44/544 (5.54) | 2.28 (1.54–3.38) | 46/426 (7.76) | 3.71 (2.52–5.46) | 32/140 (21.60) | 8.76 (5.63–13.64) | <0.0001 |
| P trend | 0.0004 | 0.02 | 0.008 | ||||
| CV mortality | |||||||
| < 120 | 160/2602 (3.84) | Ref | 85/761 (7.34) | 2.01 (1.54–2.63) | 34/106 (24.89) | 5.06 (3.45–7.42) | <0.0001 |
| 120–129 | 137/1531 (5.70) | 1.25 (0.99–1.58) | 74/517 (9.47) | 1.88 (1.42–2.49) | 23/84 (20.42) | 4.01 (2.57–6.25) | <0.0001 |
| 130–139 | 124/1073 (7.47) | 1.37 (1.08–1.73) | 73/430 (11.43) | 2.39 (1.80–3.18) | 28/78 (29.75) | 4.95 (3.28–7.46) | <0.0001 |
| 140–149 | 76/611 (8.16) | 1.35 (1.02–1.78) | 57/336 (11.41) | 2.26 (1.66–3.08) | 27/70 (30.61) | 5.00 (3.28–7.61) | <0.0001 |
| ≥ 150 | 87/544 (10.62) | 1.61 (1.22–2.11) | 102/426 (16.52) | 2.95 (2.28–3.81) | 67/140 (41.68) | 6.15 (4.56–8.29) | <0.0001 |
| P trend | 0.02 | 0.06 | 0.13 | ||||
| All-cause mortality | |||||||
| < 120 | 494/2602 (11.84) | Ref | 211/761 (18.22) | 1.49 (1.26–1.76) | 53/106 (38.79) | 2.67 (2.00–3.57) | <0.0001 |
| 120–129 | 362/1531 (15.07) | 1.12 (0.98–1.28) | 164/517 (20.99) | 1.37 (1.14–1.64) | 50/84 (44.39) | 2.80 (2.09–3.77) | <0.0001 |
| 130–139 | 283/1073 (17.06) | 1.13 (0.97–1.31) | 148/430 (23.18) | 1.59 (1.32–1.92) | 46/78 (48.87) | 2.75 (2.02–3.75) | <0.0001 |
| 140–149 | 187/611 (20.08) | 1.23 (1.04–1.47) | 121/336 (24.22) | 1.58 (1.29–1.94) | 39/70 (44.22) | 2.75 (1.97–3.83) | 0.0006 |
| ≥ 150 | 199/544 (24.29) | 1.40 (1.18–1.66) | 179/426 (29.00) | 1.75 (1.46–2.08) | 94/140 (58.48) | 3.15 (2.50–3.95) | <0.0001 |
| P trend | 0.007 | 0.36 | 0.43 | ||||
Significant values in bold.
*
Event rates per 1000 person years
†
Cox Model adjusted for: age, race, gender, body mass index, smoking status, hypertension medication use, use of cholesterol-lowering medication diagnosed diabetes, glucose, total cholesterol/ HDL-cholesterol ratio, estimated glomerular filtration rate in mL/min/1.73m2.
‡
p trends for hazard ratios of proportional hazard regression models were calculated based on the results of Wald chi-square test on linearity hypothesis of ordered NT-proBNP or SBP categories.
Abbreviations: CI indicated confidence interval; CV=cardiovascular; HR: adjusted Hazard Ratio; SBP: systolic blood pressure; n: number of events, N: number of persons at risk.