Comparison of Serum proBNP and Apelin Levels in Hypertensive Crisis Versus Controlled Hypertension: Impact of Opium Addiction Status.

Abstract

Background: Hypertension (HTN) is associated with the risk of cardiovascular diseases (CVDs) and mortality. It is estimated that by 2025, 1.6 billion people worldwide will suffer from HTN. HTN crisis is characterized by severe HTN exceeding 180/120 mmHg, leading to acute myocardial infarction (AMI), acute left ventricular failure, and intracerebral hemorrhage. Apelin and N-terminal proBNP (NT-proBNP) play a role in cardiovascular homeostasis. Opium addiction has been reported to increase the risk of CVD. In this study, we compared the serum apelin and NT-proBNP levels in HTN crisis and controlled HTN, considering the impact of addiction status among patients referred to Kerman hospitals from 2018 to 2019.

Methods: Eighty-nine patients with HTN crisis and 111 controlled HTN subjects as the control group were enrolled. Each group was further divided into two subgroups: non-addicts and opium addicts. Demographic data were recorded, and serum apelin and NT-proBNP levels were measured using the ELISA method.

Findings: Our results indicated that patients with HTN crisis had higher apelin levels than controlled HTN individuals (β=2.08, P<0.001). Among the patients with controlled HTN, diastolic blood pressure (DBP) was higher in opium-addicted subjects compared to their non-addicted counterparts (P=0.035). NT-proBNP levels were higher in opium-addicted patients with HTN crisis but higher in non-addicted patients with controlled HTN. Furthermore, mean age, SBP, DBP, HR, CR, and apelin were higher in patients with HTN crisis than those with controlled HTN, which was also statistically significant (P<0.05). However, regarding NT-proBNP levels, there was no significant difference between the two groups (P=0.175).

Conclusion: Contrary to the general belief that opium addiction has cardioprotective effects, we found that opium addiction in controlled HTN subjects was associated with higher DBP and proBNP levels were elevated in addicts with HTN crisis, indicating potential cardiac damage.