Racial differences in circulating natriuretic peptide levels: the atherosclerosis risk in communities study

Deepak K. Gupta, Brian Claggett, Quinn Wells, Susan Cheng, Man Li, Nisa Maruthur, Elizabeth Selvin, Josef Coresh, Suma Konety, Kenneth R. Butler, Thomas Mosley, Eric Boerwinkle, Ron Hoogeveen, Christie M. Ballantyne, Scott D. Solomon

Research output: Contribution to journalArticlepeer-review

40 Scopus citations


BACKGROUND: Natriuretic peptides promote natriuresis, diuresis, and vasodilation. Experimental deficiency of natriuretic peptides leads to hypertension (HTN) and cardiac hypertrophy, conditions more common among African Americans. Hospital-based studies suggest that African Americans may have reduced circulating natriuretic peptides, as compared to Caucasians, but definitive data from community-based cohorts are lacking.

METHODS AND RESULTS: We examined plasma N-terminal pro B-type natriuretic peptide (NTproBNP) levels according to race in 9137 Atherosclerosis Risk in Communities (ARIC) Study participants (22% African American) without prevalent cardiovascular disease at visit 4 (1996-1998). Multivariable linear and logistic regression analyses were performed adjusting for clinical covariates. Among African Americans, percent European ancestry was determined from genetic ancestry informative markers and then examined in relation to NTproBNP levels in multivariable linear regression analysis. NTproBNP levels were significantly lower in African Americans (median, 43 pg/mL; interquartile range [IQR], 18, 88) than Caucasians (median, 68 pg/mL; IQR, 36, 124; P<0.0001). In multivariable models, adjusted log NTproBNP levels were 40% lower (95% confidence interval [CI], -43, -36) in African Americans, compared to Caucasians, which was consistent across subgroups of age, gender, HTN, diabetes, insulin resistance, and obesity. African-American race was also significantly associated with having nondetectable NTproBNP (adjusted OR, 5.74; 95% CI, 4.22, 7.80). In multivariable analyses in African Americans, a 10% increase in genetic European ancestry was associated with a 7% (95% CI, 1, 13) increase in adjusted log NTproBNP.

CONCLUSIONS: African Americans have lower levels of plasma NTproBNP than Caucasians, which may be partially owing to genetic variation. Low natriuretic peptide levels in African Americans may contribute to the greater risk for HTN and its sequalae in this population.

Original languageEnglish (US)
JournalJournal of the American Heart Association
Issue number5
StatePublished - May 21 2015

Bibliographical note

Publisher Copyright:
© 2015 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.


  • ancestry informative markers
  • deficiency
  • hypertension
  • natriuretic peptide
  • race


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