| Research Abstract |
Subjects of community-based study were recruited from the general population (n=26,469; women 65.4%, mean age=62 years). Plasma BNP levels, serum CRP and cardiovascular risk factors were determined at baseline. Several cardiovascular endpoints (CVEs) including stroke (ischemic and hemorrhagic stroke), and heart failure (CHF) in the cohort were identified from regional stroke registry data. A multivariate Cox regression analysis was performed to analyze the relationship between plasma BNP level, serum CRP, blood pressure and the risk of the onset of CVES.
Results (1) In men, after adjustment for classical cardiovascular risk factors and atrial fibrillation, hazard ratio (HR) for ischemic stroke of the highest quartile of plasma BNP was significantly higher than that for the lowest quartile (HR=2.40; 95% CI=1.08 to 5.35; P=0.032). Increasing plasma BNP levels (1 SD increment per in log BNP values)were associated with an elevated risk of ischemic stroke (HR=1.45; 95% CI=1.01 to 2.08; P-0.0
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45). Values above the 80th percentile of plasma BNP were also associated with an increase in the risk of ischemic stroke (HR=2.88; 95% CI=1.63 to 5 09; P<0.001). Results (2) In men, after adjustment for cardiovascular risk factors, a significantly increased hazard ratio (BR) of ischemic stroke was found in the prehypertension (preHT) group (HR=2.65, 95% CI, 1.12-6.26) compared with the normotensive group, and further the HR for the onset of ischemic stroke for the PreHT with higher CRP level (> 0.5 mg/L) (FIR.=4.04, 95% CI, 1.66-9.86) was comparable to that for the hypertensive group (HR=3.98, 95% CI, 1.78-8.92). In contrast, the HR for the PreHT with lower CRP level (<0.5mg/L) (HR =1.10, 95% CI, 0.32-3.77) did not differ from that for the normotesive group. In women the PreHT group, even stratified by hsCRP level of median level was not associated with increased HR of ischemic stroke. I Results (3)After adjustment for traditional cardiovascular risk factors including atrial fibrillation, hazard ratios for CHF development for values above the 75th percentile of BNP were 13.4 (p<0.001)in men and 8.5 (p<0.001)m women. Similarly, each increment of 1SD in log BNP levels increased the hazard ratio by 8.8 (p<0.001)in men, and 6.7 (p<0.001)in women. The area under the receiver operating characteristic curve was significant for prediction of the onset of CHF (men; 0 853, women; 0.838). In addition, increased plasma BNP levels implied high risk of any-cause mortality m men (above the 75th percentile; hazard ratio=1.8, p=0.005: increment of 1SD; hazard ratio=1.4, p=0.024), but this relationship was suboptimal in women. Less
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