Increases in B-type natriuretic peptide after acute mental stress in heart failure patients are associated with alcohol consumption

Abstract

Objective: The aim of this study was to investigate in heart failure (HF) patients whether acute mental stress induces increases in the HF-severity biomarker B-type natriuretic peptide (BNP) and if alcohol consumption is associated with such stress-induced increases.

Method: Twenty-one male HF patients and 19 male non-HF controls (M = 56 years, SEM = 2) underwent a 15-minute acute mental stress test combining public speaking and mental arithmetic. Plasma levels of BNP were determined immediately before as well as 2 hours after the stress test. Alcohol consumption was assessed by self-reported number of drinks per month and history of use.

Results: HF patients had higher BNP levels before and after stress, F(1, 38) = 23.42, p < .001, and showed greater stress-induced increases in BNP levels, F(1, 38) = 4.52, p = .04, compared with controls. HF status (beta = .32, p = .015, deltaR(2) = .10) and higher alcohol consumption ((beta = .61, p< .001, deltaR(2) = .37) were independently associated with higher BNP stress increases. Moreover, higher alcohol consumption moderated the greater BNP stress increases in HF patients but not in controls (p = .49, p < .001, delta(2) = .20), although alcohol consumption did not differ between groups.

Conclusions: For individuals with HF, particularly those who drink moderate to more substantial amounts of alcohol, exposure to acute psychological stress leads to increases in circulating levels of BNP, a biomarker which is associated with increased morbidity and mortality in HF.

Figure 1

Values are means ± SEM. The figure depicts biomarker B-type natriuretic peptide (BNP) levels before and 2 hours after acute stress (Panel A) and stress-induced BNP increases (Panel B) in heart failure (HF) patients and non-HF controls who are alcohol drinkers and nondrinkers. Regression analyses revealed that belonging to the HF patient group (main effect group: β = .32, p = .015, ΔR² = .10) and having higher alcohol consumption as continuously measured by number of drinks per month (main effect drinks per month: β = .61, p < .001, ΔR² = .37) were associated with higher BNP stress increases. Moreover, higher alcohol consumption was associated with higher BNP stress increases in the HF group as compared with the non-HF control group (Group x Stress interaction: β = .49, p < .001, ΔR² = .20).