NT-ProBNP but Not High Sensitivity CRP Independently Predict Abnormal Exercise Duke Score in Well-Controlled Hypertension and Pre-Hypertension-An Study from the Subjects Undergoing Health Evaluation

Chung-Lieh Hung ； Chuan-Chuan Liu ； Hung-I Yeh ； Hung-Ju Ko ； Charles Jia-Yin Hou ； Cheng-Ho Tsai ； Yih-Jer Wu

《Acta Cardiologica Sinica》 25卷1期 (2009/03) Pp. 7-17

並列摘要

Background: Hypertension is associated with ventricular-vascular remodeling and a higher risk of coronary artery disease. However, to what extent such myocardial damage is in relation to blood pressure remains controversial. We thus sought to investigate the change of exercise stress, LV function and biomarkers in subjects with well-controlled hypertension or at pre-hypertensive stage.
Methods and Materials: Eligible subjects were divided into three subgroups: Normal Group: normotensives; Pre-HTN Group: patients at pre-hypertensive stage; Treated-HTN Group: hypertensive subjects with optimal medical control according to current treatment guidelines. Data of biomarkers, treadmill stress Duke score, and echocardiographic parameters were analyzed and compared across these three different categories.
Results: Of 125 subjects enrolled, only 106 (mean age: 49.2 year old) met the inclusion criteria. Compared with the Normal group, Pre-HTN or Treated-HTN group had a lower exercise capacity, a lower Duke risk score, and a higher NT-ProBNP level. NT-ProBNP level remained a significant predictor of Duke score index after age and gender adjustment (per Log NT-ProBNP: β-coefficient: -2.23, 95% CI: -4.06 to -0.41, P=0.02). Surprisingly, high-sensitivity c-reactive protein was not significantly different among the groups, nor was it a good predictor of Duke score index.
Conclusion: Our findings indicate that early increases of myocardial ischemic risk and NT-proBNP levels are present even in patients with pre-hypertension or well-controlled hypertension, and that NT-proBNP is capable of predicting such ischemic risk. This data suggests that an earlier and more aggressive therapeutic action may be warranted in those patients who were previously assumed to be adequately treated.

並列關鍵字

B-type natriuretic peptide ； Hypertension ； C-reactive protein ； Treadmill exercise test ； Echocardiography