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Trends in Blood Pressure and High-Sensitivity Cardiac Troponin-T with Cardiovascular Disease: The Cardiovascular Health Study.
Monday,2019-07-29 14:04 America/Los_Angeles — ecterry
| Title | Trends in Blood Pressure and High-Sensitivity Cardiac Troponin-T with Cardiovascular Disease: The Cardiovascular Health Study. |
| Publication Type | Journal Article |
| Year of Publication | 2019 |
| Authors | Tehrani, DM, Fan, W, Nambi, V, Gardin, J, Hirsch, CH, Amsterdam, E, deFilippi, CR, Polonsky, T, Wong, ND |
| Journal | Am J Hypertens |
| Date Published | 2019 Jun 21 |
| ISSN | 1941-7225 |
| Abstract | <p><b>BACKGROUND: </b>High-sensitivity cardiac troponin T (hs-cTnT) is individually associated with incident hypertension (HTN) and cardiovascular disease (CVD) events. We hypothesize that the increases in hs-cTnT with increases in blood pressure will be related to higher incidence of CVD.</p><p><b>METHODS: </b>The Cardiovascular Health Study is a longitudinal cohort of older adults. Those with hs-cTnT data and CVD risk factors at baseline and follow-up (2-3 years later) were stratified based on systolic blood pressure (SBP) (optimal: <120 mmHg, intermediate: 120-139 mmHg, elevated: ≥140 mmHg) and hs-cTnT (undetectable: <5 ng/L, detectable: 5-13 ng/L, elevated: ≥14 ng/L) categories. SBP and hs-cTnT were classified as increased or decreased if they changed categories between exams, and stable if they did not. Cox regression evaluated incident CVD events over an average 9 year follow-up.</p><p><b>RESULTS: </b>Among 2219 adults, 510 (23.0 %) had decreased hs-cTnT, 1,279 (57.6 %) had stable hs-cTnT, and 430 (19.4 %) had increased hs-cTnT. Those with increased hs-cTnT had a higher CVD risk with stable SBP (HR: 1.28 [1.04-1.57], p=0.02) or decreased SBP (HR: 1.57 [1.08-2.28], p=0.02) compared to those within the same SBP group but a stable hs-cTnT. In those with lower SBP at follow-up, there was an inverse relation between DBP and risk of CVD events in those with increased hs-cTnT (HR: 0.44 per 10 mmHg increase, p<0.01).</p><p><b>CONCLUSION: </b>An increase in hs-cTnT over time is associated with a higher risk of CVD even when the blood pressure is stable or decreases over time.</p> |
| DOI | 10.1093/ajh/hpz102 |
| Alternate Journal | Am. J. Hypertens. |
| PubMed ID | 31232455 |
ePub date:
19/06