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11-04-2010 | Cardiometabolic | Article

C-type natriuretic peptide strongly linked to arterial structure, function


Free abstract

MedWire News: The paracrine molecule C-type natriuretic peptide (CNP) is associated with functional and structural changes in the arteries, Greek scientists have discovered.

They say that levels of CNP – or its precursor product, amino-terminal pro-CNP (NT-proCNP) – may represent a novel marker of early atherosclerosis in men, and may even be involved in the underlying disease process.

Charalambos Vlachopoulos (Hippokration Hospital, Athens Medical School) and colleagues studied the relationship between CNP and arterial parameters among 117 men without established cardiovascular disease.

CNP is involved in regulating blood volume and vascular smooth-muscle tone and is vital to the maintenance of cardiovascular homeostasis, explain Vlachopoulos et al. It is a potent vasodilator but also has anti-inflammatory, antiatherogenic, antihypertrophic, and antiproliferative properties, and has been implicated in the pathophysiology of various cardiovascular conditions.

In this study, the men were stratified according to the number of vascular risk factors they possessed (0, 1, 2, or ≥3), and into tertiles of NT-proCNP levels (low [0.10–0.18 pmol/l], intermediate [0.19–0.26 pmol/l], or high [0.27–0.56 pmol/l]).

Analysis revealed that the number of vascular risk factors was significantly inversely correlated with NT-proCNP tertiles; the same was true for 10-year risk for coronary heart disease (as indicated by the Framingham risk score).

In multivariate regression analysis, log-transformed NT-proCNP levels were negatively associated with pulse-wave velocity (a marker of arterial elasticity) and intima-media thickness (a marker of early atherosclerosis), and positively associated with flow-mediated dilatation (a marker of endothelial function).

Importantly, these associations remained statistically significant after adjusting for age, blood pressure, body mass index, triglycerides, low-density lipoprotein, blood glucose, smoking status, endothelin-1, and high-sensitivity C-reactive protein.

The researchers believe this is the first study to demonstrate a clear relationship between CNP and functional/structural arterial changes.

“These findings point out the important role of CNP as a marker of vascular damage, and imply a possible contribution of this compound to the process of arterial stiffening and subclinical atherosclerosis,” they conclude in the journal Atherosclerosis.

“Further studies are warranted to establish etiological relationships and to define whether decreased CNP levels should call for more aggressive risk factor management.”

MedWire ( is an independent clinical news service provided by Current Medicine Group, a trading division of Springer Healthcare Limited. © Springer Healthcare Ltd; 2010

By Joanna Lyford