High-sensitivity cardiac troponin T in essential hypertension

Abstract

Background: Myocyte injury might be involved in the progression of essential hypertension (EHT) toward heart failure (HF). However, in the absence of high-sensitivity (hs) assay, cardiac troponin T (TnT) in EHT has not been measurable.

Methods and results: We studied 236 consecutive ambulatory patients (mean age=65.5 years; 110 men) with treated EHT (mean systolic blood pressure=134.3 mmHg, mean serum N-terminal pro-B-type natriuretic peptide=86.6 pg/ml) for mean 65.6 months. Patients with a history of HF were excluded. Single and multiple variable analyses were performed in search of clinical correlates of elevated hs-TnT (≥0.003 ng/ml). Serum concentration of hs-TnT was ≥0.003 ng/ml (mean=0.008 ng/ml) in 184 patients. By single variable analysis, age, uric acid, log-transformed N-terminal pro-B-type natriuretic peptide, brachial-ankle pulse wave velocity, Cornell electrocardiographic (ECG) voltage, and number of antihypertensive medications were associated with log-transformed hs-TnT, while hemoglobin and estimated glomerular filtration rate (eGFR) were inversely correlated with log-transformed hs-TnT. By multivariate analysis, age, eGFR and Cornell voltage were independent correlates of log-transformed hs-TnT, even after adjustment for clinical backgrounds including known prognostic biomarkers of EHT.

Conclusions: hs-TnT was ≥0.003 ng/ml in 78% of patients presenting with treated EHT and independently correlated with age, renal function, and ECG voltage of hypertrophy.