One of the first investigation on this matter showed that NT-proBNP level predicted accelerated cognitive and functional decline as well as cardiovascular morbidity and mortality in a prospective cohort study of individuals aged 85 years with a 5-year follow-up. In the last few years, an increasing body of literature has reported a significant association between NP level and the development of dementia. However, despite these important observations, no clinical guidelines include the use of NT-proBNP level for CVD risk prediction. Therefore, NPs appear able to detect the cardiovascular damage earlier before it could be clinically diagnosed and, while serving as useful markers, they play an important role in the activation of a timely defensive reaction. Based on current knowledge on the functional role of the system, it may be supposed that an elevated level of the amino-terminal-NPs in apparently healthy subjects is an index of a subtle initial cardiac and vascular damage that becomes later an overt CVD condition. Whereas the prognostic impact of NPs in patients with CVD can be easily explained as a reflection of the underlying cardiovascular dysfunction and damage, the predictive role of increased NP levels toward future cardiovascular events in apparently healthy individuals is a very intriguing and still unexplained issue. In all circumstances, higher levels of the amino-terminal natriuretic peptides (NT-proBNP and NT-proANP), the more stable forms, predict future cardiovascular events. Apart from their relevant implications in pathophysiology, diagnosis, prognosis and therapeutics of cardiovascular diseases (CVD), a role of BNP and ANP has been convincingly documented in cardiovascular prevention in several population studies, both in apparently healthy individuals and in CVD affected patients. Natriuretic peptides (NPs) are a family of cardiovascular hormones mainly secreted by the heart (atrial (ANP) and brain (BNP) natriuretic peptides) and by the endothelium (C-type natriuretic peptide (CNP)) that play important protective functions within the cardiovascular system. The available evidence suggests that they could help in identifying those subjects who would benefit most from a timely antihypertensive therapy. In the context of hypertension, elevated NT-proBNP and mid-regional (MR)-proANP levels behave as markers of brain microcirculatory damage and dysfunction. In case of a link independent from CVD risk factors, an increased NP level should be considered as a direct marker of neuronal damage. In the first case, it may be expected that, by counteracting early on the cardiovascular risk factor load and the pathological processes leading to increased aminoterminal natriuretic peptide (NT-proNP) level, the risk of dementia could be significantly reduced. In particular, it was reported that the elevation of NP levels in dementia can be both dependent and independent from CVD risk factors. A link between increased NP levels and cognitive decline and dementia has been reported in several human studies performed both in general populations and in cohorts of patients affected by cardiovascular diseases (CVDs). An increase of both brain and atrial natriuretic peptide levels, particularly of the amino-terminal peptides (NT-proBNP and NT-proANP), represents a marker of cardiovascular damage. The natriuretic peptides (NPs) belong to a family of cardiac hormones that exert relevant protective functions within the cardiovascular system.
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