title: High-Sensitivity Cardiac Troponin T and Risk of Hypertension.
abstract: BACKGROUND
  The diagnosis of hypertension is often preceded by cardiac structural abnormalities. Thus, we assessed whether high-sensitivity cardiac troponin T (hs-cTnT), a marker of subclinical myocardial damage, can identify individuals at risk for hypertension or left ventricular hypertrophy.
  
  
  RESULTS
  We studied 6516 Atherosclerosis Risk in Communities (ARIC) Study participants who were 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 blood pressure >140/90 mm Hg over 6 years). Relative to hs-cTnT <5 ng/L, adjusted hazard ratios for incident diagnosed hypertension were 1.16 (95% confidence interval, 1.08-1.25) for individuals with hs-cTnT of 5 to 8 ng/L, 1.29 (95% confidence interval, 1.14-1.47) for hs-cTnT of 9 to 13 ng/L, and 1.31 (95% confidence interval, 1.07-1.61) for hs-cTnT ≥14 ng/L (P for trend <0.001). Associations were stronger for incident visit-based hypertension. These associations were driven by higher relative hazard in normotensive people (compared with those with prehypertension; P for interaction=0.001). Baseline hs-cTnT was also strongly associated with incident left ventricular hypertrophy by electrocardiography over 6 years (eg, adjusted hazard ratio, 5.19 [95% confidence interval, 1.49-18.08] for hs-cTnT ≥14 versus <5 ng/L). Findings were not appreciably changed after accounting for competing deaths or adjusting for baseline blood pressure levels or N-terminal probrain natriuretic peptide.
  
  
  CONCLUSIONS
  In an ambulatory population with no history of cardiovascular disease, hs-cTnT was associated with incident hypertension and risk of left ventricular hypertrophy. Further research is needed to determine whether hs-cTnT can identify people who may benefit from ambulatory blood pressure monitoring or hypertension prevention lifestyle strategies.
authors.affiliation: From Department of Epidemiology and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.W.M., Y.C., A.R.S., L.J.A., W.S.P., K.M., E.S.); Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD (J.W.M., W.S.P., R.S.B.); Michael E. DeBakey Veterans Affairs Hospital, Houston, TX (V.M.); and Department of Medicine, Section of Cardiovascular Research, Baylor College of Medicine and Houston Methodist DeBakey Heart and Vascular Center, Houston, TX (V.M., C.M.B.).
authors.forename: John W
authors.initials: JW
authors.lastname: McEvoy
authors.affiliation: From Department of Epidemiology and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.W.M., Y.C., A.R.S., L.J.A., W.S.P., K.M., E.S.); Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD (J.W.M., W.S.P., R.S.B.); Michael E. DeBakey Veterans Affairs Hospital, Houston, TX (V.M.); and Department of Medicine, Section of Cardiovascular Research, Baylor College of Medicine and Houston Methodist DeBakey Heart and Vascular Center, Houston, TX (V.M., C.M.B.).
authors.forename: Yuan
authors.initials: Y
authors.lastname: Chen
authors.affiliation: From Department of Epidemiology and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.W.M., Y.C., A.R.S., L.J.A., W.S.P., K.M., E.S.); Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD (J.W.M., W.S.P., R.S.B.); Michael E. DeBakey Veterans Affairs Hospital, Houston, TX (V.M.); and Department of Medicine, Section of Cardiovascular Research, Baylor College of Medicine and Houston Methodist DeBakey Heart and Vascular Center, Houston, TX (V.M., C.M.B.).
authors.forename: Vijay
authors.initials: V
authors.lastname: Nambi
authors.affiliation: From Department of Epidemiology and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.W.M., Y.C., A.R.S., L.J.A., W.S.P., K.M., E.S.); Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD (J.W.M., W.S.P., R.S.B.); Michael E. DeBakey Veterans Affairs Hospital, Houston, TX (V.M.); and Department of Medicine, Section of Cardiovascular Research, Baylor College of Medicine and Houston Methodist DeBakey Heart and Vascular Center, Houston, TX (V.M., C.M.B.).
authors.forename: Christie M
authors.initials: CM
authors.lastname: Ballantyne
authors.affiliation: From Department of Epidemiology and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.W.M., Y.C., A.R.S., L.J.A., W.S.P., K.M., E.S.); Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD (J.W.M., W.S.P., R.S.B.); Michael E. DeBakey Veterans Affairs Hospital, Houston, TX (V.M.); and Department of Medicine, Section of Cardiovascular Research, Baylor College of Medicine and Houston Methodist DeBakey Heart and Vascular Center, Houston, TX (V.M., C.M.B.).
authors.forename: A Richey
authors.initials: AR
authors.lastname: Sharrett
authors.affiliation: From Department of Epidemiology and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.W.M., Y.C., A.R.S., L.J.A., W.S.P., K.M., E.S.); Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD (J.W.M., W.S.P., R.S.B.); Michael E. DeBakey Veterans Affairs Hospital, Houston, TX (V.M.); and Department of Medicine, Section of Cardiovascular Research, Baylor College of Medicine and Houston Methodist DeBakey Heart and Vascular Center, Houston, TX (V.M., C.M.B.).
authors.forename: Lawrence J
authors.initials: LJ
authors.lastname: Appel
authors.affiliation: From Department of Epidemiology and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.W.M., Y.C., A.R.S., L.J.A., W.S.P., K.M., E.S.); Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD (J.W.M., W.S.P., R.S.B.); Michael E. DeBakey Veterans Affairs Hospital, Houston, TX (V.M.); and Department of Medicine, Section of Cardiovascular Research, Baylor College of Medicine and Houston Methodist DeBakey Heart and Vascular Center, Houston, TX (V.M., C.M.B.).
authors.forename: Wendy S
authors.initials: WS
authors.lastname: Post
authors.affiliation: From Department of Epidemiology and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.W.M., Y.C., A.R.S., L.J.A., W.S.P., K.M., E.S.); Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD (J.W.M., W.S.P., R.S.B.); Michael E. DeBakey Veterans Affairs Hospital, Houston, TX (V.M.); and Department of Medicine, Section of Cardiovascular Research, Baylor College of Medicine and Houston Methodist DeBakey Heart and Vascular Center, Houston, TX (V.M., C.M.B.).
authors.forename: Roger S
authors.initials: RS
authors.lastname: Blumenthal
authors.affiliation: From Department of Epidemiology and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.W.M., Y.C., A.R.S., L.J.A., W.S.P., K.M., E.S.); Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD (J.W.M., W.S.P., R.S.B.); Michael E. DeBakey Veterans Affairs Hospital, Houston, TX (V.M.); and Department of Medicine, Section of Cardiovascular Research, Baylor College of Medicine and Houston Methodist DeBakey Heart and Vascular Center, Houston, TX (V.M., C.M.B.).
authors.forename: Kunihiro
authors.initials: K
authors.lastname: Matsushita
authors.affiliation: From Department of Epidemiology and Welch Center for Prevention, Epidemiology and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (J.W.M., Y.C., A.R.S., L.J.A., W.S.P., K.M., E.S.); Ciccarone Center for the Prevention of Heart Disease, Johns Hopkins University School of Medicine, Baltimore, MD (J.W.M., W.S.P., R.S.B.); Michael E. DeBakey Veterans Affairs Hospital, Houston, TX (V.M.); and Department of Medicine, Section of Cardiovascular Research, Baylor College of Medicine and Houston Methodist DeBakey Heart and Vascular Center, Houston, TX (V.M., C.M.B.). eselvin@jhu.edu.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Selvin
mesh_terms: D000368:Aged; D015415:Biomarkers / Q000097:blood; D015331:Cohort Studies; D005260:Female; D006801:Humans; D006973:Hypertension / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D020107:Troponin T / Q000097:blood*
chemical_list: D015415:Biomarkers; D020107:Troponin T
keywords: biological markers; hypertension; hypertrophy, left ventricular; prevention & control; troponin