Race-based demographic, anthropometric and clinical correlates of N-terminal-pro B-type natriuretic peptide

Int J Cardiol. 2019 Jul 1;286:145-151. doi: 10.1016/j.ijcard.2019.02.034. Epub 2019 Feb 21.


Background: Population studies have shown that black race is a natriuretic peptide (NP) deficiency state. We sought to assess whether the effects of age, sex, body mass index (BMI) and estimated glomerular filtration rate (eGFR) on N-terminal-pro-B-type NP (NT-proBNP) levels differ in white and black individuals.

Methods: The study population consisted of a stratified random cohort from the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. The study outcomes were the effects of age, sex, BMI and eGFR on NT-proBNP levels independent of socioeconomic and cardiovascular disease factors. Multivariable regression analyses were used to assess the effects of age, sex, BMI and eGFR on NT-proBNP levels in blacks and whites.

Results: Of the 27,679 participants in the weighted sample, 54.7% were females, 40.6% were black, and the median age was 64 years. Every 10-year higher age was associated with 38% [95% confidence interval (CI): 30%-45%] and 34% (95% CI: 22%-43%) higher NT-proBNP levels in whites and blacks, respectively. Female sex was associated with 31% (95% CI: 20%-43%) higher NT-proBNP levels in whites and 28% (95% CI: 15%-45%) higher in blacks. There was a significant linear inverse relationship between BMI and NT-proBNP in whites and a non-linear inverse relationship in blacks. Whites and blacks had a non-linear inverse relationship between eGFR and NT-proBNP. However, the non-linear relationship between NT-proBNP and eGFR differed by race (p = 0.01 for interaction).

Conclusions: The association of age and sex with NT-proBNP levels was similar in blacks and whites but the form of the BMI and eGFR relationship differed by race.

Keywords: Clinical correlates; NT-proBNP; Race.

Publication types

  • Multicenter Study

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anthropometry / methods*
  • Biomarkers / blood
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / ethnology*
  • Cause of Death / trends
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Morbidity / trends
  • Natriuretic Peptide, Brain / blood*
  • Peptide Fragments / blood*
  • Population Surveillance*
  • Protein Precursors
  • Risk Assessment / methods*
  • Risk Factors
  • Survival Rate / trends
  • United States / epidemiology


  • Biomarkers
  • Peptide Fragments
  • Protein Precursors
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain