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TOPLINE
Older adults who developed or continued to have heart stress, defined on the basis of elevated levels of N‑terminal pro‑B‑type natriuretic peptide (NT-proBNP), had increased risks for cardiovascular disease (CVD) and death. Adults whose heart stress normalized over time had risks similar to those in adults who never experienced heart stress.
METHODOLOGY
- Researchers conducted an observational analysis of data from a randomized trial (ASPREE) and its extension to assess whether changes in heart stress over time predicted the risks for CVD and death in older adults.
- NT-proBNP levels were measured at enrollment and 3 years later as a marker of heart stress. Cutoffs of 150 ng/L for adults aged 70-74 years and 300 ng/L for those aged 75 years or older were used to define elevated levels.
- The final analysis included 8454 adults (mean age, 78.0 years at year 3; 52.9% women) without prior CVD.
- Using the two NT‑proBNP measurements, adults were categorized as having persistently no heart stress, heart stress in remission, new‑onset heart stress, or sustained heart stress.
- The coprimary outcomes were total CVD and all-cause mortality, assessed over a median follow-up duration of 8 years following the assessment conducted at 3 years.
TAKEAWAY
- A total of 818 CVD events and 1584 deaths occurred over the follow-up duration.
- In adjusted analyses, adults with new-onset heart stress had a 7.4% higher absolute risk for CVD and a 6.1% higher absolute risk for mortality than those who remained free of heart stress.
- Adults with sustained heart stress had a 6.7% higher absolute risk for CVD and a 7.5% higher absolute risk for mortality than those who remained free of heart stress.
- The risk for CVD and mortality did not differ significantly between adults who were in remission and those who remained free of heart stress.
IN PRACTICE
"Incorporating HS [heart stress] status using longitudinal assessments of NT-proBNP may support more proactive risk stratification in older adults," the researchers wrote.
SOURCE
The study was led by Anping Cai, MD, PhD, of Guangdong Provincial People's Hospital in Guangzhou, China, and Antoni Bayes-Genis, MD, PhD, of Hospital Universitari Germans Trias i Pujol in Badalona, Spain. It was published online on August 18 in Annals of Internal Medicine.
LIMITATIONS
The study was observational; thus, researchers could not establish cause-effect relationships. Most participants were White and were relatively healthy at enrollment. NT‑proBNP levels were measured only twice.
DISCLOSURES
The study did not receive any funding. Several authors reported receiving consulting, advisory board, speaking, or other payments from pharmaceutical, diagnostics, or device companies. Some authors disclosed receiving research grants, one reported having stock options, one reported having employment support for the work, and one reported receiving travel/meeting support from a company.
This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
