Annals of Internal MedicineLongitudinal Changes in Heart Stress and the Risk for Cardiovascular Disease and Mortality in Older Adults: An Observational Study

Clinical Content (Longitudinal Observational Study)

Single NT-proBNP measurements provide cardiovascular risk information, but trajectories may offer additional context. Investigators examined three-year biomarker changes among community-dwelling older adults without previous cardiovascular disease.

Clinical Considerations

• 8,454 participants, averaging 78 years, had NT-proBNP measured at enrollment and year three.
• Incident heart stress increased eight-year adjusted cardiovascular risk by 7.4% and mortality risk by 6.1%.
• Sustained heart stress increased cardiovascular risk by 6.7% and mortality risk by 7.5%.
• Remission produced adjusted risks similar to those remaining heart-stress free.

Practice Applications

• Recognize longitudinal NT-proBNP patterns as potential risk signals.
• Interpret biomarker trajectories alongside established clinical risk factors.
• Avoid treating NT-proBNP changes as independently diagnostic.
• Monitor research evaluating biomarker-guided preventive strategies.