Atrial natriuretic peptides predict mortality in the elderly

Abstract

Wallen T, Landahl S, Hedner T, Hall C, Saito Y, Nakao K (Department of Geriatric Medicine, Vasa Hospital, and Department of Clinical Pharmacology, Sahlgrenska Hospital, University of Goteborg, Goteborg, Sweden, and Institute for Surgical Research, University of Oslo, Oslo, Norway, and Second Division, Department of Medicine, Kyoto University School of Medicine, Kyoto, Japan). Atrial natriuretic peptides predict mortality in the elderly. J Intern Med 1997; 241; 269-75. Objectives. To ascertain whether atrial natriuretic peptides could be used as prospective and independent predictors of total mortality in an elderly population. Design. Atrial natriuretic peptides, ANP(1-98) and ANP(99-126), were measured in 541 subjects from the 85-year- old population of Gothenburg, Sweden. Before the study cardiovascular disorders such as congestive heart failure, ischaemic heart disease, hypertension and atrial fibrillation were defined. Total mortality was recorded during the prospective 60-month follow-up period. Setting. Individuals aged 85 years from the population of Gothenburg, Sweden, were visited once at home and made one visit to Vasa Hospital. Main outcome measures. Sixty-month mortality in relation to circulating concentrations of atrial natriuretic peptides. Results. Circulating concentrations of ANP(1- 98) and ANP(99-126) were significantly correlated with 60-month mortality in the total study population (ANP(1-98), P < 0.001: ANP(99-126), P < 0.01). In subjects with cardiovascular disorders, 60-month mortality was significantly correlated with increased concentrations of ANP(1-98) (P < 0.01) and ANP(99- 126) (P < 0.05). In subjects with no defined cardiovascular disorder, 60- month mortality was significantly correlated with increased ANP(1-98) concentrations (P < 0.01). Conclusions. In the elderly population, atrial peptides predict mortality in subjects with defined cardiovascular disorders as well as in the total population and may predict future cardiovascular disorder.