Differences in natriuretic peptide response in self-identified white and black individuals: a physiological clinical trial
Black individuals have lower plasma natriuretic peptide (NP) concentrations than white individuals. However, race-based differences in the NP response to physiological perturbations are unknown. In this physiological trial (NCT#03070184), we measured the NP [mid-regional atrial NP (MR-proANP), N-terminal pro-B-type NP (NT-proBNP), and BNP] response to physiological perturbations among healthy, self-identified Black and white participants aged 18-40 years. The primary and secondary outcomes were the change in plasma NP concentrations at 6 weeks after metoprolol (initiated at 50 mg/day and doubled every 2 weeks) and standardized, aerobic exercise (70% of their maximal oxygen uptake on a salt-standardized background), respectively. Among 40 Black [median age: 27 (22, 32) years; 21 (52.5%) women] and 40 white [median age: 25 (20, 30) years; 19 (47.5%) women] participants, exercise increased MR-proANP (Black: 35%; white: 43%), NT-proBNP (Black: 11%; white: 23%), and BNP (Black: 59%; white: 61%) in both self-reported races. Exercise was associated with an increase in plasma MR-proANP (p<sub>interaction</sub>: 0.25) and BNP (p<sub>interaction</sub>: 0.87) concentrations which did not vary by self-reported race. However, the increase in plasma NT-proBNP concentrations were higher in white participants than in Black participants. (p<sub>interaction</sub>: 0.04) Similarly, metoprolol therapy increased MR-proANP (Black: 18%; white: 16%), NT-proBNP (Black: 95%; white: 99%), and BNP (Black: 45%; white: 74%) in both self-reported races. The metoprolol-associated increase in plasma MR-proANP (p<sub>interaction</sub>: 0.85), NT-proBNP (p<sub>interaction</sub>: 0.94), and BNP (p<sub>interaction</sub>: 0.21) concentrations were similar by self-reported race. In conclusion, the higher increase in plasma NT-proBNP concentrationsamong white patients after exercise suggests that exercise may induce significant physiological variations in NP levels. ClinicalTrials.gov ID: NCT03070184.
Authors
- Naman S. Shetty (ORCID: https://orcid.org/0000-0003-3600-126X)
- Thomas W. Buford (ORCID: https://orcid.org/0000-0002-9541-4358)
- Barbara Ann Gower (ORCID: https://orcid.org/0000-0001-8461-4613)
- Jasninder Singh Dhaliwal (ORCID: https://orcid.org/0009-0001-9099-9377)
- Pankaj Arora (ORCID: https://orcid.org/0000-0003-2420-3550)
- Thomas J. Wang (ORCID: https://orcid.org/0000-0003-4063-6508)
- Nehal Vekariya
- Krishin Yerabolu (ORCID: https://orcid.org/0009-0006-5678-7385)
- Peng Li (ORCID: https://orcid.org/0000-0002-9026-9999)
- Nirav Patel (ORCID: https://orcid.org/0000-0003-1798-1880)
- Mokshad Gaonkar (ORCID: https://orcid.org/0000-0003-0309-6813)
- Garima Arora
Institutions
- Harvard University (US)
- University of Alabama at Birmingham (US)
- Massachusetts General Hospital (US)
- Geriatric Research Education and Clinical Center (US)
- Birmingham VA Medical Center (US)
- The University of Texas Southwestern Medical Center (US)
Publication Details
- Journal
- Nature Communications
- Published
- 2025-02-13
- DOI
- https://doi.org/10.1038/s41467-024-55648-2
- Primary Topic
- Heart Failure Treatment and Management
- Type
- article
- Field-Weighted Citation Impact
- 0.00
Funders
- National Institutes of Health
- Center for Exercise Medicine, University of Alabama at Birmingham
- National Heart, Lung, and Blood Institute