Oral Presentation Australian Diabetes Society and the Australian Diabetes Educators Association Annual Scientific Meeting 2014

Relationship between NT-proBNP with 24-hour haemodynamic parameters in patients with diabetes (#60)

Renata Libianto 1 , George Jerums 1 2 , John Moran 3 , Christopher O'Callaghan 4 , Michelle Clarke 2 , Richard J MacIsaac 1 5 , Elif I Ekinci 1 2 6
  1. University of Melbourne, Melbourne
  2. Department of Endocrinology, Austin Health, Melbourne
  3. Queen Elizabeth Hospital, Adelaide
  4. Department of Clinical Pharmacology, Austin Health, Melbourne
  5. Department of Endocrinology, St Vincent's Hospital, Melbourne
  6. Menzies School of Public Health, Darwin


N-terminal pro-brain natriuretic peptide (NT-proBNP) is considered a marker of poor cardiovascular prognosis in patients with diabetes1 . Increased resting heart rate is also associated with increased cardiovascular complications and mortality in patients with diabetes2 . There is evidence that BNP modulates the autonomic nervous system3 . This study aimed to investigate the relationship between NT-proBNP and 24h haemodynamic parameters in patients with type 1 and type 2 diabetes.


Clinical characteristics, serum NT-proBNP level and 24h ambulatory blood pressure were collected in 141patients with type 1 and type 2 diabetes who attended diabetes clinics at Austin Health, a tertiary referral centre in Melbourne. A multiple regression model was generated to predict log10(NT-proBNP), with the following variables as potential predictors: 24h systolic, diastolic and mean arterial blood pressure; morning blood pressure surge; night-to-day systolic blood pressure ratio; 24h heart rate; age; sex and BMI.


The mean age was 64±13 years, 65% were males, and 74% had type 2 diabetes. The mean 24h systolic, diastolic and mean arterial pressure was 130±13, 70±9, and 91±8 mmHg, respectively. The mean 24h heart rate was 73±10 bpm. In a multiple regression model, night-to-day systolic blood pressure ratio, age, and 24h heart rate significantly predicted log10(NT-proBNP) (R2=0.4, p<0.001, Figures 1a-c).


In patients with diabetes, lack of nocturnal blood pressure dipping is associated with increased NT-proBNP level. Further studies are needed to define the relationship between heart rate and NT-proBNP. 


  1. Bruno et al, Diabetes Care 2013
  2. Hillis et al, Diabetologia 2012
  3. Brunner-La Rocca et al, J Am Coll Cardiol 2001