Comparison Of N-Terminal Pro-B-Type Natriuretic Peptide Level In Primary Aldosteronism And Essential Hypertension

Primary aldosteronism (PA) represents the most common cause of secondary hypertension. A higher risk of cardiovascular events has been reported in patients with PA than in otherwise similar patients with essential hypertension (EH). So far, only a few studies investigated the levels of plasma N-terminal pro-B-type natriuretic peptide (NT-proBNP) levels in PA patients compared to EH patients.We studied 385 consecutive patients with PA and 385 with EH individually matched for age, gender, body mass index (BMI), blood pressure values and duration of hypertension. Fasting blood samples were obtained from all patients in our institution. Plasma levels of NT-proBNP and other clinical medical data were measured.Two groups were similar in age, gender, BMI, office blood pressure and duration of hypertension. However, higher log-NT-proBNP level (1.74 ± 0.41 versus 1.50 ± 0.46, P < 0.001), left ventricular mass index (113 ± 25 versus 102 ± 26 g/m, P < 0.001), night-time systolic blood pressure (SBP) (130 ± 16 versus 127 ± 17 mmHg, P = 0.01) and night-time diastolic blood pressure (DBP) (82 ± 10 versus 79 ± 11 mmHg, P < 0.01) were found in patients with PA compared with those with EH. The night-time BP decline was significantly attenuated in PA group. Univariate linear regression analysis showed that office systolic blood pressure (SBP) (r = 0.221, p < 0.001), 24 h mean SBP (r = 0.215, p < 0.001), plasma aldosterone levels were positively correlated with log-NT-proBNP levels.In this study, patients with PA show higher NT-proBNP levels and night-time blood pressure than those with EH. We hypothesize that these changes may play a role for the increased risk of future cardiovascular events in PA patients.