Background: N-terminal pro-brain natriuretic peptide (NtproBNP) and N -termi nal pro-atrial natriuretic peptide (Nt-proANP) are strong cardiovascular risk markers in patients with chronic heart failure, as well as in the general popula tion. We investigated whether high Nt-proBNP or NtproANP could also predict the composite endpoint (CEP) of cardiovascular death, non-fatal stroke or non-fat al myocardial infarction in patients with hypertension and left ventricular (LV) hypertrophy. Methods: After 2 weeks of placebo treatment, clinical, laboratory and echocardiographic variables were assessed in 183 hypertensive participants i n the LIFE echo substudy with electrocardiographic LV hypertrophy. Nt-proBNP an d Nt-proANP were measured by immunoassay at baseline. The patients were followe d for 60 ±5 months. Results: Using Cox regression analysis, the 25 CEP were pre dicted by In(Nt-proBNP) (hazard ratio 1.61 per 2.73-fold increase, P < 0.01) a s well as In(Nt-pro-ANP) (hazard ratio 2.93, P < 0.05). Nt-proBNP above the m edian value of 21.8 pmol/ml was associated with higher incidence of CEP (19.6 versus 7.7%, P < 0.05). Nt-proBNP above the median value was associated with higher incidence of CEP in the 123 patients without history of diabetes or cardiovascular diseas e (14.8 versus 4.3%, P < 0.05), but the association was insignificant in the 60 patients with a history of diabetes or cardiovascular disease (26.3 versus 18.2 %, NS). Nt-proANP showed the same tendency. Conclusion: Nt-proBNP, more than Nt-proANP, strongly predicts cardiovascular events in patients with hypertensio n and LV hypertrophy, especially in patients without diabetes or clinically over t cardiovascular disease.
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