An observational study found that older adults with consistently elevated N-terminal pro–B-type natriuretic peptide (NT-proBNP) concentrations, a blood marker linked to heart stress (HS), had a significantly higher risk for cardiovascular disease and death, while those whose elevated levels returned to normal had a risk similar to people who never showed signs of heart stress. The findings suggest that monitoring longitudinal changes to heart stress in older adults may help identify those at greater risk for future cardiovascular disease and death. The findings are published in Annals of Internal Medicine.
Researchers from Monash University, Shanghai Jiao Tong University School of Medicine, and colleagues analyzed data from 8,454 adults aged 70 and older who had no history of cardiovascular disease and participated in the ASPREE (ASPirin in Reducing Events in the Elderly) trial and its extension study. They measured NT-proBNP at study enrollment and again three years later, then grouped participants into one of four categories: persistently HS-free (no HS at either visit), HS remission (HS at trial enrollment but not at year 3), incident HS (no HS at trial enrollment but HS at year 3), and sustained HS (HS at both visits). Over a median follow-up of eight years, participants with incident or sustained heart stress faced higher risks for cardiovascular disease and all-cause mortality, while those categorized in heart stress remission had comparable risks to those who remained heart stress free. The findings suggest that monitoring longitudinal changes in NT-proBNP values may improve assessment of cardiovascular and mortality risk in older adults; however, the authors note that the heart stress should be considered as a marker of subclinical cardiac dysfunction rather than a modifiable therapeutic target.
In an accompanying editorial, Karen P. Alexander, MD discusses how population-based research cohorts with asymptomatic older adults provide a unique opportunity to evaluate NT-proBNP prevalence and prognostic significance. Dr. Alexander argues how NT-proBNP could become a valuable component of wellness testing in older adults given its ability to identify low and potentially modifiable risk while also providing a measure of biologic aging.
Abstract: https://www.acpjournals.org/doi/10.7326/ANNALS-26-00245
Editorial: https://www.acpjournals.org/doi/10.7326/ANNALS-26-02897
(Newswise/HG)