High-Sensitivity Cardiac Troponin T and Risk of Hypertension
Background—Hypertension is often preceded by cardiac structural abnormalities. Thus, we assessed whether high-sensitivity cardiac troponin-T (hs-cTNT), a marker of chronic subclinical myocardial damage, can identify persons at risk for hypertension or left ventricular hypertrophy (LVH).
Methods and Results—We studied 6,516 ARIC Study participants, 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 BP >140/90 mmHg over 6 years). Relative to hs-cTNT <5ng/L, adjusted hazard ratios for incident diagnosed hypertension were 1.16 (95% CI 1.08, 1.25) for persons with hs-cTNT 5-8ng/L, 1.29 (1.14, 1.47) for hs-cTNT 9-13ng/L, and 1.31 (1.07, 1.61) for hs-cTNT ≥14ng/L (p-trend <0.001). Associations were stronger for incident visit-based hypertension. These associations were driven by higher relative hazard in normotensive persons (compared to those with prehypertension, p-interaction=0.001). Baseline hs-cTNT was also strongly associated with incident LVH by electrocardiography over 6 years (e.g. adjusted HR 5.19 [1.49-18.08] for hs-cTNT ≥14ng/L vs <5ng/L). Findings were not appreciably changed after accounting for competing deaths or adjustment for baseline BP levels or NT-proBNP.
Conclusions—In an ambulatory population with no history of cardiovascular disease, hs-cTNT was associated with incident hypertension and risk of LVH. Further research is needed to determine whether hs-cTNT can identify persons who may benefit from ambulatory BP monitoring or hypertension prevention lifestyle strategies.
- Received November 17, 2014.
- Revision received June 10, 2015.
- Accepted June 25, 2015.