Influence of Sex and Hormone Status on Circulating Natriuretic Peptides

Objectives The aim of this study was to assess the relationship between sex hormones and natriuretic peptide levels in community-based adults. Background Women have higher circulating natriuretic peptide concentrations than men, but the mechanisms for these sex-related differences and the impact of hormone therapy are unclear. Experimental studies suggest that androgens may suppress natriuretic peptide secretion. Methods We measured N-terminal pro–B-type natriuretic peptide (NT-proBNP), total testosterone, and sex hormone–binding globulin plasma levels in 4,056 men and women (mean age 40 ± 9 years) from the Framingham Heart Study Third-Generation cohort. Sex/hormone status was grouped as: 1) men; 2) post-menopausal women not receiving hormone replacement therapy; 3) pre-menopausal women not receiving hormonal contraceptives; 4) post-menopausal women receiving hormone replacement therapy; and 5) pre-menopausal women receiving hormonal contraceptives. Results Circulating NT-proBNP levels were associated with sex/hormone status (overall p Conclusions These findings suggest that lower levels of circulating androgens and the potentiating effect of exogenous female hormone therapy contribute to the higher circulating NT-proBNP concentrations in women.