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Hypertension. 2015 Jan;65(1):78-84. doi: 10.1161/HYPERTENSIONAHA.114.04206. Epub 2014 Oct 27.

High-sensitivity troponin T and cardiovascular events in systolic blood pressure categories: atherosclerosis risk in communities study.

Author information

1
From the Department of Medicine, Michael E. DeBakey Veterans Affairs Hospital, Houston, TX (S.S.V., B.B., V.N.); Baylor College of Medicine, Houston, TX (Y.P., W.S., G.E.T., S.S.V., R.C.H., B.B., C.M.B., V.N.); Department of Medicine, Methodist DeBakey Heart Center, Houston, TX (Y.P., S.S.V., R.C.H., C.M.B., V.N.); Department of Medicine, University of Texas Southwestern Medical Center, Dallas (J.A.d.L.); Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX (S.S.V., B.B., C.M.B., V.N.); Department of Medicine, Johns Hopkins University, Baltimore, MD (C.E.N., J.C.); Department of Medicine, University of Mississippi Medical Center, Jackson (T.H.M.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (J.D.W.); Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (G.H.); Department of Epidemiology, School of Public Health, University of Texas Health Science Center at Houston (E.A.B.); and Department of Medicine, Harvard Medical School, Boston, MA (S.D.S.).
2
From the Department of Medicine, Michael E. DeBakey Veterans Affairs Hospital, Houston, TX (S.S.V., B.B., V.N.); Baylor College of Medicine, Houston, TX (Y.P., W.S., G.E.T., S.S.V., R.C.H., B.B., C.M.B., V.N.); Department of Medicine, Methodist DeBakey Heart Center, Houston, TX (Y.P., S.S.V., R.C.H., C.M.B., V.N.); Department of Medicine, University of Texas Southwestern Medical Center, Dallas (J.A.d.L.); Cardiovascular Research Institute, Baylor College of Medicine, Houston, TX (S.S.V., B.B., C.M.B., V.N.); Department of Medicine, Johns Hopkins University, Baltimore, MD (C.E.N., J.C.); Department of Medicine, University of Mississippi Medical Center, Jackson (T.H.M.); National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD (J.D.W.); Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill (G.H.); Department of Epidemiology, School of Public Health, University of Texas Health Science Center at Houston (E.A.B.); and Department of Medicine, Harvard Medical School, Boston, MA (S.D.S.). vnambi@bcm.edu.

Abstract

Based on observational studies, there is a linear increase in cardiovascular risk with higher systolic blood pressure (SBP), yet clinical trials have not shown benefit across all SBP categories. We assessed whether troponin T measured using high-sensitivity assay was associated with cardiovascular disease within SBP categories in 11 191 Atherosclerosis Risk in Communities study participants. Rested sitting SBP by 10-mm Hg increments and troponin categories were identified. Incident heart failure hospitalization, coronary heart disease, and stroke were ascertained for a median of 12 years after excluding individuals with corresponding disease. Approximately 53% of each type of cardiovascular event occurred in individuals with SBP<140 mm Hg and troponin T ≥3 ng/L. Higher troponin T was associated with increasing cardiovascular events across most SBP categories. The association was strongest for heart failure and least strong for stroke. There was no similar association of SBP with cardiovascular events across troponin T categories. Individuals with troponin T ≥3 ng/L and SBP <140 mm Hg had higher cardiovascular risk compared with those with troponin T <3 ng/L and SBP 140 to 159 mm Hg. Higher troponin T levels within narrow SBP categories portend increased cardiovascular risk, particularly for heart failure. Individuals with lower SBP but measurable troponin T had greater cardiovascular risk compared with those with suboptimal SBP but undetectable troponin T. Future trials of systolic hypertension may benefit by using high-sensitivity troponin T to target high-risk patients.

KEYWORDS:

cardiovascular diseases; heart failure; hypertension

PMID:
25350984
PMCID:
PMC4268376
DOI:
10.1161/HYPERTENSIONAHA.114.04206
[Indexed for MEDLINE]
Free PMC Article

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