High-Sensitivity troponin t and cardiovascular events in systolic blood pressure categories atherosclerosis risk in communities study

Yashashwi Pokharel, Wensheng Sun, James A de Lemos, George E. Taffet, Salim S. Virani, Chiadi E. Ndumele, Thomas H. Mosley, Ron C. Hoogeveen, Josef Coresh, Jacqueline D. Wright, Gerardo Heiss, Eric A. Boerwinkle, Biykem Bozkurt, Scott D. Solomon, Christie M. Ballantyne, Vijay Nambi

Research output: Contribution to journalArticle

17 Citations (Scopus)

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.

Original languageEnglish (US)
Pages (from-to)78-84
Number of pages7
JournalHypertension
Volume65
Issue number1
DOIs
StatePublished - Jan 20 2015

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Troponin
Atherosclerosis
Blood Pressure
Troponin T
Heart Failure
Stroke

Keywords

  • Cardiovascular Diseases
  • Heart Failure
  • Hypertension

ASJC Scopus subject areas

  • Internal Medicine

Cite this

High-Sensitivity troponin t and cardiovascular events in systolic blood pressure categories atherosclerosis risk in communities study. / Pokharel, Yashashwi; Sun, Wensheng; de Lemos, James A; Taffet, George E.; Virani, Salim S.; Ndumele, Chiadi E.; Mosley, Thomas H.; Hoogeveen, Ron C.; Coresh, Josef; Wright, Jacqueline D.; Heiss, Gerardo; Boerwinkle, Eric A.; Bozkurt, Biykem; Solomon, Scott D.; Ballantyne, Christie M.; Nambi, Vijay.

In: Hypertension, Vol. 65, No. 1, 20.01.2015, p. 78-84.

Research output: Contribution to journalArticle

Pokharel, Y, Sun, W, de Lemos, JA, Taffet, GE, Virani, SS, Ndumele, CE, Mosley, TH, Hoogeveen, RC, Coresh, J, Wright, JD, Heiss, G, Boerwinkle, EA, Bozkurt, B, Solomon, SD, Ballantyne, CM & Nambi, V 2015, 'High-Sensitivity troponin t and cardiovascular events in systolic blood pressure categories atherosclerosis risk in communities study', Hypertension, vol. 65, no. 1, pp. 78-84. https://doi.org/10.1161/HYPERTENSIONAHA.114.04206
Pokharel, Yashashwi ; Sun, Wensheng ; de Lemos, James A ; Taffet, George E. ; Virani, Salim S. ; Ndumele, Chiadi E. ; Mosley, Thomas H. ; Hoogeveen, Ron C. ; Coresh, Josef ; Wright, Jacqueline D. ; Heiss, Gerardo ; Boerwinkle, Eric A. ; Bozkurt, Biykem ; Solomon, Scott D. ; Ballantyne, Christie M. ; Nambi, Vijay. / High-Sensitivity troponin t and cardiovascular events in systolic blood pressure categories atherosclerosis risk in communities study. In: Hypertension. 2015 ; Vol. 65, No. 1. pp. 78-84.
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