Evidence map›Paper›PMID 26746175›Full record

Observational studyCirculation2016

N-Terminal Pro-Brain Natriuretic Peptide and Heart Failure Risk Among Individuals With and Without Obesity: The Atherosclerosis Risk in Communities (ARIC) Study.

Chiadi E Ndumele, Kunihiro Matsushita, Yingying Sang, Mariana Lazo, Sunil K Agarwal, Vijay Nambi, Anita Deswal, Roger S Blumenthal, Christie M Ballantyne, Josef Coresh and 1 more

Open access · bronzeAbstract readComparative StudyObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Circulation, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 64 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
64citing papers in PubMed, 2 pooled it
11.0field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

64 citing papers in PubMed, 2 syntheses or guidelines pooled it, 118 citations in OpenAlex.

  1. Pooled it
  2. Natriuretic peptides in bronchopulmonary dysplasia: a systematic review.Journal of perinatology : official journal of the California Perinatal Association · 2020
    Pooled it
  3. Trial
  4. [Application of esmolol in severe hand, foot, and mouth disease].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2017
    Trial
  5. Review
  6. Article
  7. Article
  8. Biomarkers in Heart Failure: A Review and a Wish.International journal of molecular sciences · 2025
    Review
  9. Article
  10. Article
  11. Review
  12. Blunted increase in plasma BNP during acute coronary syndrome attacks in obese patients.International journal of cardiology. Heart & vasculature · 2024
    Article
  13. Article
  14. Sex-based Differences in Heart Failure Biomarkers.Current heart failure reports · 2024
    Review
  15. Article
  16. Review
  17. Article
  18. Article
  19. Article
  20. Article

4 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 4 institutions in 1 country.

Chiadi E NdumeleFrom Johns Hopkins Ciccarone Center for the Prevention of Heart Disease(C.E.N., R.S.B.) and Department of General Internal Medicine(M.L., J.C., E.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD(C.E.N., K.M., Y.S., M.L., J.C., E.S.); Division of Cardiology, Mount Sinai School of Medicine, New York, NY(S.K.A.); Division of Atherosclerosis and Vascular Medicine(V.N., C.M.B.) and Section of Cardiology(A.D.), Baylor College of Medicine, Houston, TX; Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TX(V.N., C.M.B.); and Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston TX(A.D., V.N.). cndumel2@jhmi.edu.
Kunihiro MatsushitaFrom Johns Hopkins Ciccarone Center for the Prevention of Heart Disease(C.E.N., R.S.B.) and Department of General Internal Medicine(M.L., J.C., E.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD(C.E.N., K.M., Y.S., M.L., J.C., E.S.); Division of Cardiology, Mount Sinai School of Medicine, New York, NY(S.K.A.); Division of Atherosclerosis and Vascular Medicine(V.N., C.M.B.) and Section of Cardiology(A.D.), Baylor College of Medicine, Houston, TX; Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TX(V.N., C.M.B.); and Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston TX(A.D., V.N.).
Yingying SangFrom Johns Hopkins Ciccarone Center for the Prevention of Heart Disease(C.E.N., R.S.B.) and Department of General Internal Medicine(M.L., J.C., E.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD(C.E.N., K.M., Y.S., M.L., J.C., E.S.); Division of Cardiology, Mount Sinai School of Medicine, New York, NY(S.K.A.); Division of Atherosclerosis and Vascular Medicine(V.N., C.M.B.) and Section of Cardiology(A.D.), Baylor College of Medicine, Houston, TX; Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TX(V.N., C.M.B.); and Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston TX(A.D., V.N.).
Mariana LazoFrom Johns Hopkins Ciccarone Center for the Prevention of Heart Disease(C.E.N., R.S.B.) and Department of General Internal Medicine(M.L., J.C., E.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD(C.E.N., K.M., Y.S., M.L., J.C., E.S.); Division of Cardiology, Mount Sinai School of Medicine, New York, NY(S.K.A.); Division of Atherosclerosis and Vascular Medicine(V.N., C.M.B.) and Section of Cardiology(A.D.), Baylor College of Medicine, Houston, TX; Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TX(V.N., C.M.B.); and Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston TX(A.D., V.N.).
Sunil K AgarwalFrom Johns Hopkins Ciccarone Center for the Prevention of Heart Disease(C.E.N., R.S.B.) and Department of General Internal Medicine(M.L., J.C., E.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD(C.E.N., K.M., Y.S., M.L., J.C., E.S.); Division of Cardiology, Mount Sinai School of Medicine, New York, NY(S.K.A.); Division of Atherosclerosis and Vascular Medicine(V.N., C.M.B.) and Section of Cardiology(A.D.), Baylor College of Medicine, Houston, TX; Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TX(V.N., C.M.B.); and Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston TX(A.D., V.N.).
Vijay NambiFrom Johns Hopkins Ciccarone Center for the Prevention of Heart Disease(C.E.N., R.S.B.) and Department of General Internal Medicine(M.L., J.C., E.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD(C.E.N., K.M., Y.S., M.L., J.C., E.S.); Division of Cardiology, Mount Sinai School of Medicine, New York, NY(S.K.A.); Division of Atherosclerosis and Vascular Medicine(V.N., C.M.B.) and Section of Cardiology(A.D.), Baylor College of Medicine, Houston, TX; Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TX(V.N., C.M.B.); and Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston TX(A.D., V.N.).
Anita DeswalFrom Johns Hopkins Ciccarone Center for the Prevention of Heart Disease(C.E.N., R.S.B.) and Department of General Internal Medicine(M.L., J.C., E.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD(C.E.N., K.M., Y.S., M.L., J.C., E.S.); Division of Cardiology, Mount Sinai School of Medicine, New York, NY(S.K.A.); Division of Atherosclerosis and Vascular Medicine(V.N., C.M.B.) and Section of Cardiology(A.D.), Baylor College of Medicine, Houston, TX; Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TX(V.N., C.M.B.); and Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston TX(A.D., V.N.).
Roger S BlumenthalFrom Johns Hopkins Ciccarone Center for the Prevention of Heart Disease(C.E.N., R.S.B.) and Department of General Internal Medicine(M.L., J.C., E.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD(C.E.N., K.M., Y.S., M.L., J.C., E.S.); Division of Cardiology, Mount Sinai School of Medicine, New York, NY(S.K.A.); Division of Atherosclerosis and Vascular Medicine(V.N., C.M.B.) and Section of Cardiology(A.D.), Baylor College of Medicine, Houston, TX; Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TX(V.N., C.M.B.); and Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston TX(A.D., V.N.).
Christie M BallantyneFrom Johns Hopkins Ciccarone Center for the Prevention of Heart Disease(C.E.N., R.S.B.) and Department of General Internal Medicine(M.L., J.C., E.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD(C.E.N., K.M., Y.S., M.L., J.C., E.S.); Division of Cardiology, Mount Sinai School of Medicine, New York, NY(S.K.A.); Division of Atherosclerosis and Vascular Medicine(V.N., C.M.B.) and Section of Cardiology(A.D.), Baylor College of Medicine, Houston, TX; Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TX(V.N., C.M.B.); and Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston TX(A.D., V.N.).
Josef CoreshFrom Johns Hopkins Ciccarone Center for the Prevention of Heart Disease(C.E.N., R.S.B.) and Department of General Internal Medicine(M.L., J.C., E.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD(C.E.N., K.M., Y.S., M.L., J.C., E.S.); Division of Cardiology, Mount Sinai School of Medicine, New York, NY(S.K.A.); Division of Atherosclerosis and Vascular Medicine(V.N., C.M.B.) and Section of Cardiology(A.D.), Baylor College of Medicine, Houston, TX; Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TX(V.N., C.M.B.); and Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston TX(A.D., V.N.).
Elizabeth SelvinFrom Johns Hopkins Ciccarone Center for the Prevention of Heart Disease(C.E.N., R.S.B.) and Department of General Internal Medicine(M.L., J.C., E.S.), Johns Hopkins University School of Medicine, Baltimore, MD; Department of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD(C.E.N., K.M., Y.S., M.L., J.C., E.S.); Division of Cardiology, Mount Sinai School of Medicine, New York, NY(S.K.A.); Division of Atherosclerosis and Vascular Medicine(V.N., C.M.B.) and Section of Cardiology(A.D.), Baylor College of Medicine, Houston, TX; Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart and Vascular Center, Houston, TX(V.N., C.M.B.); and Section of Cardiology, Michael E. DeBakey Veterans Affairs Medical Center, Houston TX(A.D., V.N.).
Icahn School of Medicine at Mount Sinai · USHouston Methodist · USBaylor College of Medicine · USJohns Hopkins University · US

Funding

Diabetes and Prediabetes in Older Adults in ARICR01DK089174 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI SELVIN, ELIZABETH · 2011 to 2020
$6.4M
The Relationship of Obesity with Subclinical Myocardial Injury and Heart FailureK23HL122447 · NHLBI · JOHNS HOPKINS UNIVERSITY · PI NDUMELE, CHIADI E · 2014 to 2018
$919k
Research and Mentoring in the Clinical Epidemiology of Type 2 DiabetesK24DK106414 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI SELVIN, ELIZABETH · 2015 to 2019
$654k
NHLBI NIH HHS HHSN268201100005CNHLBI NIH HHS HHSN268201100005GNHLBI NIH HHS HHSN268201100005INHLBI NIH HHS HHSN268201100006CNHLBI NIH HHS HHSN268201100007CNHLBI NIH HHS HHSN268201100007INHLBI NIH HHS HHSN268201100008CNHLBI NIH HHS HHSN268201100008INHLBI NIH HHS HHSN268201100009CNHLBI NIH HHS HHSN268201100009INHLBI NIH HHS HHSN268201100010CNHLBI NIH HHS HHSN268201100011CNHLBI NIH HHS HHSN268201100011INHLBI NIH HHS HHSN268201100012CNHLBI NIH HHS K23 HL122447NHLBI NIH HHS K23HL12247NIDDK NIH HHS K24 DK106414NIDDK NIH HHS K24DK106414NIDDK NIH HHS R01 DK089174NIDDK NIH HHS R01DK089174PHS HHS HHSN268201100005CPHS HHS HHSN268201100006CPHS HHS HHSN268201100007CPHS HHS HHSN268201100008CPHS HHS HHSN268201100009CPHS HHS HHSN268201100010CPHS HHS HHSN268201100011CPHS HHS HHSN268201100012C
6 · The paper itself

Abstract

backgroundObesity is a risk factor for heart failure (HF) but is associated with lower N-terminal pro-brain natriuretic peptide (NT-proBNP) levels. It is unclear whether the prognostic value and implications of NT-proBNP levels for HF risk differ across body mass index (BMI) categories. METHODS AND

resultsWe followed up 12 230 ARIC participants free of prior HF at baseline (visit 2, 1990-1992) with BMI ≥18.5 kg/m(2). We quantified and compared the relative and absolute risk associations of NT-proBNP with incident HF across BMI categories. There were 1861 HF events during a median 20.6 years of follow-up. Despite increased HF risk in obesity, a weak inverse association was seen between baseline BMI and NT-proBNP levels (r=-0.10). Nevertheless, higher baseline NT-proBNP was associated with increased HF risk in all BMI categories. NT-proBNP improved HF risk prediction overall, even among those with severe obesity (BMI ≥35 kg/m(2); improvement in C statistic, 0.032; 95% confidence interval, 0.011-0.053). However, given the higher HF rates among those with obesity, at each NT-proBNP level, higher BMI was associated with greater absolute HF risk. Indeed, among those with NT-proBNP of 100 to <200 pg/mL, the average 10-year HF risk was <5% among normal-weight individuals but >10% among the severely obese.

conclusionsDespite its inverse relationship with BMI, NT-proBNP provides significant prognostic information on the risk of developing HF even among individuals with obesity. Given the higher baseline HF risk among persons with obesity, even slight elevations in NT-proBNP may have implications for increased absolute HF risk in this population.

Indexed as

Residence CharacteristicsAtherosclerosisBiomarkersCohort StudiesFemaleFollow-Up StudiesHeart FailureHumansMaleMiddle AgedNatriuretic Peptide, BrainObesityPeptide FragmentsProspective StudiesRisk FactorsBiomarkersNatriuretic Peptide, BrainPeptide Fragmentspro-brain natriuretic peptide (1-76)epidemiologyheart failurenatriuretic peptidesobesityrisk assessment

Identifiers

PMID26746175
PMCPMC4758863
OpenAlexW2280514257

What OpenQuestion holds

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Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.