Association between N-terminal pro B-type natriuretic peptide and day-to-day blood pressure and heart rate variability in a general population: The Ohasama study

Background: In addition to day-to-day variability in blood pressure (BP) or heart rate (HR), N-terminal pro B-type natriuretic peptide (NT-proBNP) has been reported to be a predictor of cardiovascular disease. Here, we tested the hypothesis that day-to-day BP or HR variability calculated as the intraindividual standard deviation (SD) of home BP or HR is associated with elevated NT-proBNP in a cross-sectional study. Methods: Among 664 participants (mean age, 61.9 years; female, 70.5%) from a general Japanese population without a history of heart disease, 86 (13.0%) had NT-proBNP at least 125pg/ml. Results: Each 1 SD increase in the SD of home systolic BP (SBP) [odds ratio (OR), 1.82; P<.0001) and in the SD of home HR (OR, 1.44; P=0.008) were significantly associated with the prevalence of NT-proBNP at least 125pg/ml after adjustment for possible confounding factors including home SBP and HR. Among the four groups defined by the median SD of home SBP and of home HR, the group with higher SDs in home SBP (≥8.0mmHg) and HR (≥5.0bpm) had the greatest OR for the prevalence of NT-proBNP at least 125pg/ml (OR, 4.80; P=0007 vs. a reference group with lower SDs of home SBP and HR). Conclusion: These results suggest that day-to-day variability in BP and HR may be associated with target-organ damage or complications, which can lead to an elevated NT-proBNP level. An elevated NT-proBNP level may be involved in the prognostic significance of day-to-day variability in BP or HR.