Biomarkers associated with pulse pressure in African-Americans and non-hispanic whites

Thais Coutinho, Stephen T. Turner, Thomas H. Mosley, Iftikhar J. Kullo

Research output: Contribution to journalArticlepeer-review

20 Scopus citations


Background Pulse pressure (an indirect measure of arterial stiffness) is a robust predictor of cardiovascular events, but its pathophysiology remains poorly understood. To gain insight into the pathophysiology of arterial stiffness we conducted an exploratory investigation of the associations of 47 circulating biomarkers in etiologic pathways of arteriosclerosis with brachial artery pulse pressure. Methods Participants included 1,193 African-Americans and 1,145 non-Hispanic whites belonging to hypertensive sibships. Blood pressure (BP) was measured with a random-zero sphygmomanometer. Multivariable linear regression was employed to assess the associations of biomarkers with pulse pressure after adjustment for age, sex, conventional risk factors, mean arterial pressure, heart rate, and use of aspirin, statins, estrogens, and antihypertensives. Statistical significance was set at P≤ 0.001 (Bonferroni correction for multiple testing). Results Log N-terminal probrain natriuretic peptide (NT-proBNP) (African-Americans: Β = 2.11 ± 0.52, non-Hispanic whites: Β = 2.65 ± 0.55), log midregional proatrial natriuretic peptide (African-Americans: Β = 4.83 ± 0.70, non-Hispanic whites: Β = 3.70 ± 0.67), and log osteoprotegerin (African-Americans: Β = 4.64 ± 1.02, non-Hispanic whites: Β = 4.19 ± 0.99) were independently associated with pulse pressure (P 0.001 for all) in both ethnicities. Log C-reactive protein (CRP) (Β = 1.56 ± 0.35), log midregional proadrenomedullin (MR-proADM) (Β = 5.53 ± 1.19) and log matrix metalloproteinase-2 (Β = 3.89 ± 1.06) were associated with greater pulse pressure in African-Americans only (P≤ 0.001 for all), whereas higher fibrinogen was associated with pulse pressure in non-Hispanic whites only (Β = 0.02 ± 0.004. P< 0.001). Conclusions Our results suggest that hemodynamic stress, vascular inflammation and calcification, and matrix remodeling may have a role in the pathogenesis and/or adverse consequences of increased pulse pressure.

Original languageEnglish (US)
Pages (from-to)145-151
Number of pages7
JournalAmerican journal of hypertension
Issue number2
StatePublished - Feb 2012


  • adrenomedullin
  • arterial stiffness
  • atrial natriuretic peptide
  • biomarkers
  • blood pressure
  • brain natriuretic peptide
  • fibrinogen
  • hypertension
  • matrix metalloproteinase-2
  • osteoprotegerin
  • pulse pressure

ASJC Scopus subject areas

  • Internal Medicine


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