Lack of activation of molecular forms of the BNP system in human grade 1 hypertension and relationship to cardiac hypertrophy

Paola Belluardo, Alessandro Cataliotti, Lorena Bonaiuto, Eliana Giuffré, Egle Maugeri, Paola Noto, Giovanna Orlando, Giuseppa Raspa, Brigida Piazza, Luciano Babuin, Horng H. Chen, Fernando L. Martin, Paul M. McKie, Denise M. Heublein, John C. Burnett, Lorenzo S. Malatino

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47 Scopus citations


We evaluated relationships among two circulating molecular forms of brain natriuretic peptide (BNP32 and NT-proBNP), severity of hypertension (HTN), and cardiac hypertrophy in subjects with mild, moderate, and severe HTN. We prospectively studied 78 patients (43 males; mean age 51.4 ± 11 yr) with essential HTN and 28 age- and sex-matched controls. BNP32 and NT-proBNP were measured by radioimmunoassay. In grade 1 HTN, BNP32 was not elevated and NT-proBNP was reduced (P = 0.030) compared with controls. However, log-transformed values of BNP32 and NT-proBNP were both increased with severity of HTN from grade 1 to 3 (P <0.0001 and P = 0.003, respectively). By multivariate analysis, log BNP32 was independently predicted by age (β = 0.210, P = 0.026) and HTN grade (β = 0.274, P = 0.004), whereas log NT-proBNP was independently predicted by sex (β = 0.235, P = 0.012) and HTN grade (β = 0.218, P = 0.0023). Two forms of BNP were measured in normal subjects and patients with essential HTN. In grade 1 HTN, BNP32 was unchanged and NT-proBNP was significantly reduced compared with controls. As severity increased in humans with grade 1 to 3 HTN, both BNP32 and NT-proBNP levels were increased while not being affected by the presence of left ventricular hypertrophy. The lack of activation of BNP32 together with the reduction of NT-proBNP in grade 1 HTN may represent an impaired response of the BNP system in the early phase of HTN. The later activation of both forms of BNP may be a late compensatory effect, because it correlates with severity of HTN rather than cardiac hypertrophy/remodeling.

Original languageEnglish (US)
Pages (from-to)H1529-H1535
JournalAmerican Journal of Physiology - Heart and Circulatory Physiology
Issue number4
StatePublished - 2006


  • Amino-terminal pro-brain natriuretic peptide
  • Brain natriuretic peptide
  • Left ventricular hypertrophy
  • Natriuretic peptide

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)


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