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Differences in natriuretic peptide response in self-identified white and black individuals: a physiological clinical trial

Author

Listed:
  • Naman S. Shetty

    (Massachusetts General Hospital
    Harvard Medical School)

  • Mokshad Gaonkar

    (University of Alabama at Birmingham)

  • Nirav Patel

    (University of Alabama at Birmingham)

  • Nehal Vekariya

    (University of Alabama at Birmingham)

  • Krishin Yerabolu

    (University of Alabama at Birmingham)

  • Jasninder S. Dhaliwal

    (University of Alabama at Birmingham)

  • Thomas W. Buford

    (University of Alabama at Birmingham
    Birmingham Veterans Affairs Medical Center)

  • Barbara Gower

    (University of Alabama at Birmingham)

  • Peng Li

    (University of Alabama at Birmingham)

  • Thomas J. Wang

    (University of Texas-Southwestern Medical Center)

  • Garima Arora

    (University of Alabama at Birmingham)

  • Pankaj Arora

    (University of Alabama at Birmingham
    Birmingham Veterans Affairs Medical Center)

Abstract

Black individuals have lower plasma natriuretic peptide (NP) concentrations than white individuals. However, race-based differences in the NP response to physiological perturbations are unknown. In this physiological trial (NCT#03070184), we measured the NP [mid-regional atrial NP (MR-proANP), N-terminal pro-B-type NP (NT-proBNP), and BNP] response to physiological perturbations among healthy, self-identified Black and white participants aged 18-40 years. The primary and secondary outcomes were the change in plasma NP concentrations at 6 weeks after metoprolol (initiated at 50 mg/day and doubled every 2 weeks) and standardized, aerobic exercise (70% of their maximal oxygen uptake on a salt-standardized background), respectively. Among 40 Black [median age: 27 (22, 32) years; 21 (52.5%) women] and 40 white [median age: 25 (20, 30) years; 19 (47.5%) women] participants, exercise increased MR-proANP (Black: 35%; white: 43%), NT-proBNP (Black: 11%; white: 23%), and BNP (Black: 59%; white: 61%) in both self-reported races. Exercise was associated with an increase in plasma MR-proANP (pinteraction: 0.25) and BNP (pinteraction: 0.87) concentrations which did not vary by self-reported race. However, the increase in plasma NT-proBNP concentrations were higher in white participants than in Black participants. (pinteraction: 0.04) Similarly, metoprolol therapy increased MR-proANP (Black: 18%; white: 16%), NT-proBNP (Black: 95%; white: 99%), and BNP (Black: 45%; white: 74%) in both self-reported races. The metoprolol-associated increase in plasma MR-proANP (pinteraction: 0.85), NT-proBNP (pinteraction: 0.94), and BNP (pinteraction: 0.21) concentrations were similar by self-reported race. In conclusion, the higher increase in plasma NT-proBNP concentrationsamong white patients after exercise suggests that exercise may induce significant physiological variations in NP levels. ClinicalTrials.gov ID: NCT03070184.

Suggested Citation

  • Naman S. Shetty & Mokshad Gaonkar & Nirav Patel & Nehal Vekariya & Krishin Yerabolu & Jasninder S. Dhaliwal & Thomas W. Buford & Barbara Gower & Peng Li & Thomas J. Wang & Garima Arora & Pankaj Arora, 2025. "Differences in natriuretic peptide response in self-identified white and black individuals: a physiological clinical trial," Nature Communications, Nature, vol. 16(1), pages 1-9, December.
    • Handle: RePEc:nat:natcom:v:16:y:2025:i:1:d:10.1038_s41467-024-55648-2
    DOI: 10.1038/s41467-024-55648-2
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