Influence of sex and hormone status on circulating natriuretic peptides.

Journal Article (Journal Article)

OBJECTIVES: The aim of this study was to assess the relationship between sex hormones and natriuretic peptide levels in community-based adults. BACKGROUND: Women have higher circulating natriuretic peptide concentrations than men, but the mechanisms for these sex-related differences and the impact of hormone therapy are unclear. Experimental studies suggest that androgens may suppress natriuretic peptide secretion. METHODS: We measured N-terminal pro-B-type natriuretic peptide (NT-proBNP), total testosterone, and sex hormone-binding globulin plasma levels in 4,056 men and women (mean age 40 ± 9 years) from the Framingham Heart Study Third-Generation cohort. Sex/hormone status was grouped as: 1) men; 2) post-menopausal women not receiving hormone replacement therapy; 3) pre-menopausal women not receiving hormonal contraceptives; 4) post-menopausal women receiving hormone replacement therapy; and 5) pre-menopausal women receiving hormonal contraceptives. RESULTS: Circulating NT-proBNP levels were associated with sex/hormone status (overall p < 0.0001). Men had lower NT-proBNP levels than women of all menopause or hormone groups, and women receiving hormonal contraceptives had higher NT-proBNP levels than women who were not receiving hormone therapy (all p < 0.0001). These relationships remained significant after adjusting for age, body mass index, and cardiovascular risk factors. Across sex/hormone status groups, free testosterone (FT) levels decreased and sex hormone-binding globulin levels increased in tandem with increasing NT-proBNP levels. In sex-specific analyses, NT-proBNP levels decreased across increasing quartiles of FT in men (p for trend <0.01) and women (p for trend <0.0001). Adjustment for FT markedly attenuated the association between sex/hormone status and NT-proBNP concentrations. CONCLUSIONS: These findings suggest that lower levels of circulating androgens and the potentiating effect of exogenous female hormone therapy contribute to the higher circulating NT-proBNP concentrations in women.

Full Text

Duke Authors

Cited Authors

  • Lam, CSP; Cheng, S; Choong, K; Larson, MG; Murabito, JM; Newton-Cheh, C; Bhasin, S; McCabe, EL; Miller, KK; Redfield, MM; Vasan, RS; Coviello, AD; Wang, TJ

Published Date

  • August 2, 2011

Published In

Volume / Issue

  • 58 / 6

Start / End Page

  • 618 - 626

PubMed ID

  • 21798425

Pubmed Central ID

  • PMC3170816

Electronic International Standard Serial Number (EISSN)

  • 1558-3597

Digital Object Identifier (DOI)

  • 10.1016/j.jacc.2011.03.042


  • eng

Conference Location

  • United States