Racial Differences in Circulating Natriuretic Peptide Levels: The XXXX Risk in Communities Study.

@entity1 @entity101 @entity6 @entity28 @entity1283 @entity731 @entity65
BACKGROUND: Natriuretic peptides promote natriuresis, diuresis, and vasodilation. Experimental deficiency of natriuretic peptides leads to @entity101 ( @entity101 ) and @entity1283 , conditions more common among African Americans. Hospital-based studies suggest that African Americans may have reduced circulating natriuretic peptides, as compared to Caucasians, but definitive data from community-based cohorts are lacking. METHODS AND RESULTS: We examined plasma N-terminal pro B-type natriuretic peptide (NTproBNP) levels according to race in 9137 @entity731 Risk in Communities (ARIC) Study @entity1 (22% African American) without prevalent @entity65 at visit 4 (1996-1998). Multivariable linear and logistic regression analyses were performed adjusting for clinical covariates. Among African Americans, percent European ancestry was determined from genetic ancestry informative markers and then examined in relation to NTproBNP levels in multivariable linear regression analysis. NTproBNP levels were significantly lower in African Americans (median, 43 pg/mL; interquartile range [IQR], 18, 88) than Caucasians (median, 68 pg/mL; IQR, 36, 124; P<0.0001). In multivariable models, adjusted log NTproBNP levels were 40% lower (95% confidence interval [CI], -43, -36) in African Americans, compared to Caucasians, which was consistent across subgroups of age, gender, @entity101 , @entity6 , insulin resistance, and @entity28 . African-American race was also significantly associated with having nondetectable NTproBNP (adjusted OR, 5.74; 95% CI, 4.22, 7.80). In multivariable analyses in African Americans, a 10% increase in genetic European ancestry was associated with a 7% (95% CI, 1, 13) increase in adjusted log NTproBNP. CONCLUSIONS: African Americans have lower levels of plasma NTproBNP than Caucasians, which may be partially owing to genetic variation. Low natriuretic peptide levels in African Americans may contribute to the greater risk for @entity101 and its sequalae in this population.
