Differences in Natriuretic Peptide Levels by Race/Ethnicity (From the Multi-Ethnic Study of Atherosclerosis)

Deepak K. Gupta, Lori B. Daniels, Susan Cheng, Christopher R. deFilippi, Michael H. Criqui, Alan S. Maisel, Joao A. Lima, Hossein Bahrami, Philip Greenland, Mary Cushman, Russell Tracy, David Siscovick, Alain G. Bertoni, Valentina Cannone, John C. Burnett, John Jeffrey Carr, Thomas J. Wang

Research output: Contribution to journalArticlepeer-review

28 Scopus citations


Natriuretic peptides (NP) are cardiac-derived hormones with favorable cardiometabolic actions. Low NP levels are associated with increased risks of hypertension and diabetes mellitus, conditions with variable prevalence by race and ethnicity. Heritable factors underlie a significant proportion of the interindividual variation in NP concentrations, but the specific influences of race and ancestry are unknown. In 5597 individuals (40% white, 24% black, 23% Hispanic, and 13% Chinese) without prevalent cardiovascular disease at baseline in the Multi-Ethnic Study of Atherosclerosis, multivariable linear regression and restricted cubic splines were used to estimate differences in serum N-terminal pro B-type natriuretic peptide (NT-proBNP) levels according to, ethnicity, and ancestry. Ancestry was determined using genetic ancestry informative markers. NT-proBNP concentrations differed significantly by race and ethnicity (black, median 43 pg/ml [interquartile range 17 to 94], Chinese 43 [17 to 90], Hispanic 53 [23 to 107], white 68 [34 to 136]; p = 0.0001). In multivariable models, NT-proBNP was 44% lower (95% confidence interval −48 to −40) in black and 46% lower (−50 to −41) in Chinese, compared with white individuals. Hispanic individuals had intermediate concentrations. Self-identified blacks and Hispanics were the most genetically admixed. Among self-identified black individuals, a 20% increase in genetic European ancestry was associated with 12% higher (1% to 23%) NT-proBNP. Among Hispanic individuals, genetic European and African ancestry were positively and negatively associated with NT-proBNP levels, respectively. In conclusion, NT-proBNP levels differ according to race and ethnicity, with the lowest concentrations in black and Chinese individuals. Racial and ethnic differences in NT-proBNP may have a genetic basis, with European and African ancestry associated with higher and lower NT-proBNP concentrations, respectively.

Original languageEnglish (US)
Pages (from-to)1008-1015
Number of pages8
JournalAmerican Journal of Cardiology
Issue number6
StatePublished - Sep 15 2017

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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