High-Sensitivity Cardiac Troponin T and Risk of Hypertension
John W McEvoy1, Yuan Chen1, Vijay Nambi1
1From Department of Epidemiology and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.W.M., Y.C., A.R.S., L.J.A., W.S.P., K.M., E.S.); Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD (J.W.M., W.S.P., R.S.B.); Michael E. DeBakey Veterans Affairs Hospital, Houston, TX (V.M.); and Department of Medicine, Section of Cardiovascular Research, Baylor College of Medicine and Houston Methodist DeBakey Heart and Vascular Center, Houston, TX (V.M., C.M.B.).
Insights
High-sensitivity cardiac troponin T (hs-cTnT) can identify individuals at risk for developing hypertension and left ventricular hypertrophy. This cardiac biomarker may aid in early detection and prevention strategies for cardiovascular disease.
Area of Science:
- Cardiology
- Biomarkers
- Hypertension Research
Background:
- Hypertension diagnosis often follows cardiac structural changes.
- Subclinical myocardial damage may precede hypertension.
- High-sensitivity cardiac troponin T (hs-cTnT) is a marker of myocardial damage.
Purpose of the Study:
- Assess if hs-cTnT identifies individuals at risk for hypertension.
- Determine if hs-cTnT predicts left ventricular hypertrophy.
- Investigate hs-cTnT as an early risk indicator for cardiovascular conditions.
Main Methods:
- Utilized data from 6516 Atherosclerosis Risk in Communities (ARIC) Study participants.
- Examined associations between baseline hs-cTnT levels and incident hypertension over 19.9 years.
- Assessed hs-cTnT association with incident left ventricular hypertrophy over 6 years.
Main Results:
- Elevated hs-cTnT levels were significantly associated with increased risk of diagnosed and visit-based hypertension.
- Associations were stronger in normotensive individuals compared to those with prehypertension.
- Baseline hs-cTnT showed a strong association with incident left ventricular hypertrophy.
Conclusions:
- In an asymptomatic population, hs-cTnT is linked to incident hypertension and left ventricular hypertrophy risk.
- Further research is needed to explore hs-cTnT's role in guiding hypertension prevention and monitoring.
- hs-cTnT may help identify individuals who could benefit from early interventions.
Background:
The diagnosis of hypertension is often preceded by cardiac structural abnormalities. Thus, we assessed whether high-sensitivity cardiac troponin T (hs-cTnT), a marker of subclinical myocardial damage, can identify individuals at risk for hypertension or left ventricular hypertrophy.
Methods And Results:
We studied 6516 Atherosclerosis Risk in Communities (ARIC) Study participants who were free of prevalent hypertension and cardiovascular disease at baseline (1990-1992). We examined the association of baseline hs-cTnT categories with incident diagnosed hypertension (defined by self-report of a diagnosis or medication use during a maximum of 19.9 years of follow-up) and with incident visit-based hypertension (defined by self-report, medication use, or measured blood pressure >140/90 mm Hg over 6 years). Relative to hs-cTnT <5 ng/L, adjusted hazard ratios for incident diagnosed hypertension were 1.16 (95% confidence interval, 1.08-1.25) for individuals with hs-cTnT of 5 to 8 ng/L, 1.29 (95% confidence interval, 1.14-1.47) for hs-cTnT of 9 to 13 ng/L, and 1.31 (95% confidence interval, 1.07-1.61) for hs-cTnT ≥14 ng/L (P for trend <0.001). Associations were stronger for incident visit-based hypertension. These associations were driven by higher relative hazard in normotensive people (compared with those with prehypertension; P for interaction=0.001). Baseline hs-cTnT was also strongly associated with incident left ventricular hypertrophy by electrocardiography over 6 years (eg, adjusted hazard ratio, 5.19 [95% confidence interval, 1.49-18.08] for hs-cTnT ≥14 versus <5 ng/L). Findings were not appreciably changed after accounting for competing deaths or adjusting for baseline blood pressure levels or N-terminal probrain natriuretic peptide.
Conclusions:
In an ambulatory population with no history of cardiovascular disease, hs-cTnT was associated with incident hypertension and risk of left ventricular hypertrophy. Further research is needed to determine whether hs-cTnT can identify people who may benefit from ambulatory blood pressure monitoring or hypertension prevention lifestyle strategies.
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