Plasma B-type natriuretic peptide reflects left ventricular hypertrophy and diastolic function in hypertension

Background: Hypertension is associated with changes in concentrations of vasoactive peptides and procollagen propeptides, but their relationships with left ventricular hypertrophy and cardiac function are unclear. Methods: We measured plasma levels of atrial natriuretic peptide (ANP), its amino terminal propeptide (NT-proANP), B-type natriuretic peptide (BNP), endothelin-1 (ET-1), and serum levels of the aminoterminal propeptide of type I procollagen (PINP) and the aminoterminal propeptide of type III procollagen (PIIINP) and echocardiographic parameters in 97 patients with hypertension in the Anglo-Scandinavian Cardiac Outcomes Trial. Results: Median values (reference values) of the peptides were: ANP 11.2 (6.9–14.9) pmol/l, NT-proANP 351 (143–311) pmol/l, BNP 1.1 (0.4–7.2) pmol/l, ET-1 8.7 (1.2–5.0) pmol/l, PIIINP 2.8 (1.7–4.2) μg/l and PINP 29 (19–84) μg/l. Plasma BNP levels in patients with left ventricular hypertrophy (1.2 pmol/l) and patients with echocardiographic signs of diastolic dysfunction (1.5 pmol/l) were greater than those in patients without hypertrophy (0.7 pmol/l) and normal diastolic parameters (0.9 pmol/l) (p<0.05). BNP was the only biochemical parameter that independently predicted interventricular septal diastolic diameter (p<0.05), left ventricular mass index (p<0.01) and ratio of the velocity–time integrals of the E and A waves of the mitral inflow in a stepwise logistic regression analysis (p<0.05). Conclusions: The results show that BNP reflects the remodelling process in hypertension.