NT-proBNP is associated with fibulin-1 in Africans: The SAfrEIC study

ObjectivesThe N-terminal prohormone B-type natriuretic peptide (NT-proBNP) is involved in the regulation of volume load and secreted when systemic cardiac overload occurs. Fibulin-1 on the other hand is a component of many extracellular matrix proteins including those present in atherosclerotic lesions, expressed in elastin-containing fibres of blood vessels, and also in the heart. Due to an alarming prevalence of hypertensive heart disease in black South Africans, we investigated the associations of NT-proBNP with fibulin-1 and markers of arterial stiffness in Africans and Caucasians.MethodsWe included 231 Africans and 238 Caucasians from South Africa aged 22-77 years. Serum NT-proBNP and fibulin-1 levels were determined, and arterial compliance and pulse wave velocity were measured.ResultsAfricans had significantly higher blood pressure and NT-proBNP levels than Caucasians and African men had higher fibulin-1 levels than Caucasian men. In single regression analysis, NT-proBNP was significantly associated with fibulin-1 in African men and Caucasian women. NT-proBNP correlated negatively with arterial compliance in all groups except Caucasian women. After partial adjustments, the association between NT-proBNP and fibulin-1 strengthened in African men only. After full adjustment in multiple regression analysis, the association of NT-proBNP with fibulin-1 was confirmed in African men (R2 = 0.41; β = 0.26; p < 0.01) and also in younger women (R2 = 0.34; β = 0.251; p = 0.012).ConclusionsOnly Africans indicated a significant independent association between NT-proBNP and fibulin-1, suggesting that cardiovascular alterations are already present in this relatively young African population as opposed to Caucasians.

► We explored NT-proBNP and fibulin-1 in Africans and Caucasians. ► A positive relationship exists between NT-proBNP and fibulin-1 in African men. ► This association remains independent of age, blood pressure and kidney function. ► Our results suggest possible early vascular changes present in this population. ► This was confirmed in younger African men, increasing their risk for cardiac damage.