Level and Change in N-Terminal Pro-B-Type Natriuretic Peptide and Kidney Function and Survival to Age 90

J Gerontol A Biol Sci Med Sci. 2021 Feb 25;76(3):478-484. doi: 10.1093/gerona/glaa124.

Abstract

Background: Many traditional cardiovascular risk factors do not predict survival to very old age. Studies have shown associations of estimated glomerular filtration rate (eGFR) and N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) with cardiovascular disease and mortality in older populations. This study aimed to evaluate the associations of the level and change in eGFR and NT-pro-BNP with longevity to age 90 years.

Method: The population included participants (n = 3,645) in the Cardiovascular Health Study, aged between 67 and 75 at baseline. The main exposures were eGFR, calculated with the Berlin Initiative Study (BIS) 2 equation, and NT-pro-BNP, and the main outcome was survival to age 90. Mixed models were used to estimate level and change of the main exposures.

Results: There was an association between baseline level and change of both eGFR and NT-pro-BNP and survival to 90, and this association persisted after adjustment for covariates. Each 10 mL/min/1.73 m2 higher eGFR level was associated with an adjusted odds ratio (OR) of 1.23 (95% CI: 1.13, 1.34) of survival to 90, and a 0.5 mL/min/1.73 m2 slower decline in eGFR was associated with an OR of 1.51 (95% CI: 1.31, 1.74). A twofold higher level of NT-pro-BNP level had an adjusted OR of 0.67 (95% CI: 0.61, 0.73), and a 1.05-fold increase per year in NT-pro-BNP had an OR of 0.53 (95% CI: 0.43, 0.65) for survival to age 90.

Conclusion: eGFR and NT-pro-BNP appear to be important risk factors for longevity to age 90.

Keywords: Longevity; NT-pro-BNP; eGFR.

Publication types

  • Observational Study
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Biomarkers / blood
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / diagnosis
  • Cardiovascular Diseases / epidemiology*
  • Cohort Studies
  • Female
  • Glomerular Filtration Rate / physiology*
  • Humans
  • Kidney Diseases / blood
  • Kidney Diseases / diagnosis
  • Kidney Diseases / epidemiology*
  • Longevity*
  • Male
  • Natriuretic Peptide, Brain / blood*
  • Odds Ratio
  • Peptide Fragments / blood*
  • Risk Factors
  • Survival Rate

Substances

  • Biomarkers
  • Peptide Fragments
  • pro-brain natriuretic peptide (1-76)
  • Natriuretic Peptide, Brain