Trends in blood pressure and high-sensitivity cardiac troponin-T with cardiovascular disease: The cardiovascular health study

David M. Tehrani; Wenjun Fan; Vijay Nambi; Julius Gardin; Calvin H. Hirsch; Ezra Amsterdam; Christopher R. deFilippi; Tamar Polonsky; Nathan D. Wong

doi:10.1093/ajh/hpz102

Trends in blood pressure and high-sensitivity cardiac troponin-T with cardiovascular disease: The cardiovascular health study

David M. Tehrani
, Wenjun Fan
, Vijay Nambi
, Julius Gardin
, Calvin H. Hirsch
, Ezra Amsterdam
, Christopher R. deFilippi
, Tamar Polonsky
, Nathan D. Wong

Research output: Contribution to journal › Article › peer-review

Abstract

BACKGROUND 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. METHODS 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 mm Hg, intermediate: 120–139 mm Hg, elevated: ≥140 mm Hg) 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. RESULTS Among 2,219 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 (hazard ratio [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 diastolic blood pressure (DBP) and risk of CVD events in those with increased hs-cTnT (HR: 0.44 per 10 mm Hg increase, P < 0.01). CONCLUSION 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.

Original language	American English
Pages (from-to)	1013-1020
Number of pages	8
Journal	American journal of hypertension
Volume	32
Issue number	10
DOIs	https://doi.org/10.1093/ajh/hpz102
State	Published - Nov 1 2019
Externally published	Yes

ASJC Scopus subject areas

Internal Medicine

Keywords

Blood pressure
Cardiovascular disease
High-sensitivity troponin
Hypertension

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10.1093/ajh/hpz102

Cite this

@article{a5b9f25433494b618d179051a68dfc48,

title = "Trends in blood pressure and high-sensitivity cardiac troponin-T with cardiovascular disease: The cardiovascular health study",

abstract = "BACKGROUND 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. METHODS 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 mm Hg, intermediate: 120–139 mm Hg, elevated: ≥140 mm Hg) 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. RESULTS Among 2,219 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 (hazard ratio [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 diastolic blood pressure (DBP) and risk of CVD events in those with increased hs-cTnT (HR: 0.44 per 10 mm Hg increase, P < 0.01). CONCLUSION 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.",

keywords = "Blood pressure, Cardiovascular disease, High-sensitivity troponin, Hypertension",

author = "Tehrani, \{David M.\} and Wenjun Fan and Vijay Nambi and Julius Gardin and Hirsch, \{Calvin H.\} and Ezra Amsterdam and deFilippi, \{Christopher R.\} and Tamar Polonsky and Wong, \{Nathan D.\}",

year = "2019",

month = nov,

day = "1",

doi = "10.1093/ajh/hpz102",

language = "American English",

volume = "32",

pages = "1013--1020",

journal = "American journal of hypertension",

issn = "0895-7061",

publisher = "Oxford University Press",

number = "10",

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TY - JOUR

T1 - Trends in blood pressure and high-sensitivity cardiac troponin-T with cardiovascular disease

T2 - The cardiovascular health study

AU - Tehrani, David M.

AU - Fan, Wenjun

AU - Nambi, Vijay

AU - Gardin, Julius

AU - Hirsch, Calvin H.

AU - Amsterdam, Ezra

AU - deFilippi, Christopher R.

AU - Polonsky, Tamar

AU - Wong, Nathan D.

PY - 2019/11/1

Y1 - 2019/11/1

N2 - BACKGROUND 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. METHODS 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 mm Hg, intermediate: 120–139 mm Hg, elevated: ≥140 mm Hg) 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. RESULTS Among 2,219 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 (hazard ratio [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 diastolic blood pressure (DBP) and risk of CVD events in those with increased hs-cTnT (HR: 0.44 per 10 mm Hg increase, P < 0.01). CONCLUSION 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.

AB - BACKGROUND 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. METHODS 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 mm Hg, intermediate: 120–139 mm Hg, elevated: ≥140 mm Hg) 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. RESULTS Among 2,219 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 (hazard ratio [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 diastolic blood pressure (DBP) and risk of CVD events in those with increased hs-cTnT (HR: 0.44 per 10 mm Hg increase, P < 0.01). CONCLUSION 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.

KW - Blood pressure

KW - Cardiovascular disease

KW - High-sensitivity troponin

KW - Hypertension

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UR - https://www.scopus.com/pages/publications/85072629111#tab=citedBy

U2 - 10.1093/ajh/hpz102

DO - 10.1093/ajh/hpz102

M3 - Article

C2 - 31232455

SN - 0895-7061

VL - 32

SP - 1013

EP - 1020

JO - American journal of hypertension

JF - American journal of hypertension

IS - 10

ER -

Trends in blood pressure and high-sensitivity cardiac troponin-T with cardiovascular disease: The cardiovascular health study

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ASJC Scopus subject areas

Keywords

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