CHARACTERISTICS OF THE PARTICIPANTS WITH INCREASED NT-PROBNP, EHUH 2 STUDY

Objective: Cardiovascular disease (CVD) is the primary cause of death in Croatia. Increased NT-proBNP is associated with CV morbidity, chronic kidney disease (CKD) and pulmonary embolism. As such, NT-proBNP provides valuable insight into an individual’s CVD risk in asymptomatic people. The aim of the study was to determine the distribution of plasma levels of NT-proBNP in a representative sample of adult population of the Republic of Croatia, and to analyze characteristics of subjects with elevated values. Design and method: Under the EHUH-2 project, 2021 subjects were invited to participate in the study with randomization lists, of which 1181 participants underwent all examinations specified by the protocol. For the present work, sub-analyses were performed to investigate the distribution of NT-proBNP in the general population and to explore the differences among NT-proBNP group A (125-399), group B (400-738) and group C (> 739). Results: The distribution of NT-proBNP is shown in Figure 1. Group C was the oldest with the highest prevalence of men (62.9% vs. 27.1% in group A; p=0.0005). History of hypertension, stroke, heart failure, diabetes and CKD were higher in group C vs. group A (85% vs. 67.4%; p=0.06, 3.8% vs. 1.6%; p=0.001, 4.1% vs.2.3%; p>0.05; 38.4% vs. 18.4%;p=0.014<, 44% vs. 12.5% p=0.0004, respectively). C group had higher systolic blood pressure (145.7 vs. 139.3), waist circumference (107 vs. 99), ePWV (12.68 vs. 11.08), fasting blood glucose (6.4 vs. 5.5) and urate levels (416 vs. 300) with lower hemoglobin levels (138 vs. 140) and eGFR (59.6 vs. 81.3). There were no significant differences in lipid values. Interestingly, neutrophil/lymphocyte and neutrophil/HDL ratios were higher in group C than in group A (9.56 vs. 7.21; 48.47 vs. 43.44, respectively).Conclusions: Elevated values of NT-proBNP were associated with CV morbidity, higher cardio-kidney-metabolic risk factors and some novel biomarkers of inflammation, atherogenesis and metabolic disturbances which are all linked to higher global risk. Determination of NT-proBNP should be incorporated not only in regular clinical examination of all hypertensive and CKD patients but could also be considered for screening asymptomatic subjects for CVD risk in high-risk populations.