Academic Journal
A Clinical Prediction Model for Selective NT-proBNP Testing in Hypertension.
| Τίτλος: | A Clinical Prediction Model for Selective NT-proBNP Testing in Hypertension. |
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| Συγγραφείς: | Cai A; Department of Cardiology, Hypertension Research Laboratory, Guangdong Cardiovascular Institute, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Southern Medical University, Guangzhou, China.; Department of Cardiology, People's Hospital of Yingde City, Yingde, Guangdong Province, China., Liu L; Department of Medicine, School of Clinical Medicine, The University of Hong Kong, Hong Kong, China., Yu X; Department of Cardiology, People's Hospital of Yingde City, Yingde, Guangdong Province, China., Wu D; Department of Cardiology, People's Hospital of Yingde City, Yingde, Guangdong Province, China., Lin X; Department of Cardiology, People's Hospital of Yingde City, Yingde, Guangdong Province, China., Luo S; Department of Cardiology, People's Hospital of Yingde City, Yingde, Guangdong Province, China., Liu K; Department of Cardiology, People's Hospital of Yingde City, Yingde, Guangdong Province, China. |
| Πηγή: | Journal of clinical hypertension (Greenwich, Conn.) [J Clin Hypertens (Greenwich)] 2026 Jun; Vol. 28 (6), pp. e70310. |
| Τύπος έκδοσης: | Journal Article |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: Wiley Periodicals Inc Country of Publication: United States NLM ID: 100888554 Publication Model: Print Cited Medium: Internet ISSN: 1751-7176 (Electronic) Linking ISSN: 15246175 NLM ISO Abbreviation: J Clin Hypertens (Greenwich) Subsets: MEDLINE |
| Imprint Name(s): | Publication: Original Publication: Greenwich, CT : Le Jacq Communication, Inc., c1999- |
| Ιατρικοί όροι (MeSH): | Natriuretic Peptide, Brain*/blood , Natriuretic Peptide, Brain*/analysis , Hypertension*/blood , Hypertension*/diagnosis , Hypertension*/epidemiology , Hypertension*/physiopathology , Hypertension*/complications , Peptide Fragments*/blood , Peptide Fragments*/analysis , Heart Failure*/diagnosis , Heart Failure*/epidemiology , Heart Failure*/blood, Biomarkers/blood ; United States/epidemiology ; Blood Pressure/physiology ; Humans ; Male ; Female ; Middle Aged ; Nutrition Surveys ; Adult ; Aged ; Predictive Value of Tests ; Risk Factors ; Prediction Algorithms |
| Περίληψη: | N-terminal pro-B-type natriuretic peptide (NT-proBNP) testing is recommended for pre-heart failure (pre-HF) screening. However, universal NT-proBNP testing is infeasible and inefficient. We analyzed data from 4642 U.S. adults with hypertension in NHANES 1999-2004. Heart stress, a biomarker-defined pre-HF state, was defined using age-specific NT-proBNP cutoffs. Multivariable logistic regression was used to identify factors associated with prevalent heart stress, and a point-based score was constructed. Model discrimination and calibration were internally validated using 1000 bootstrapped samples. Heart stress was present in 31% of individuals with hypertension. Factors associated with heart stress included older age, current smoking, prior coronary heart disease/myocardial infarction, higher systolic blood pressure, lower diastolic blood pressure, and reduced estimated glomerular filtration rate. The derivation model showed acceptable discrimination (AUC 0.71; 95% CI 0.70-0.73) and good calibration. An optimal cutoff of 6 points was identified using the Youden index and was internally validated (AUC 0.71; 95% CI 0.69-0.74). Model performance was consistent across race/ethnicity and body mass index subgroups, with relatively lower discrimination in females than in males (AUC 0.66 vs. 0.78). When stratified by a predicted heart stress probability threshold of 50%, individuals in the higher-probability group had higher cumulative risk of all-cause (hazard ratio 3.90; 95% CI 3.55-4.29) and cardiovascular mortality (hazard ratio 5.18; 95% CI 4.44-6.04) than those in the lower-probability group. These findings suggest that a simple model using readily obtainable clinical variables can help identify individuals with hypertension who are likely to have prevalent heart stress, offering a practical strategy to guide selective NT-proBNP testing. (© 2026 The Author(s). The Journal of Clinical Hypertension published by Wiley Periodicals LLC.) |
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| Contributed Indexing: | Keywords: biomarker; discrimination; hypertension; mortality; screening |
| Substance Nomenclature: | 114471-18-0 (Natriuretic Peptide, Brain) 0 (pro-brain natriuretic peptide (1-76)) 0 (Peptide Fragments) 0 (Biomarkers) |
| Entry Date(s): | Date Created: 20260619 Date Completed: 20260619 Latest Revision: 20260817 |
| Update Code: | 20260817 |
| PubMed Central ID: | PMC13280469 |
| DOI: | 10.1111/jch.70310 |
| PMID: | 42317108 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1751-7176 |
|---|---|
| DOI: | 10.1111/jch.70310 |