Associations of ambulatory blood pressure measurements with high-sensitivity troponin and natriuretic peptide levels in SPRINT

Nikit Venishetty; Jarett D Berry; James A de Lemos; Elaine Wu; Min Jae Lee; Paul E Drawz; Vijay Nambi; Christie M Ballantyne; Anthony A Killeen; Joachim H Ix; Michael G Shlipak; Simon B Ascher

doi:10.1093/ajh/hpae035

Associations of ambulatory blood pressure measurements with high-sensitivity troponin and natriuretic peptide levels in SPRINT

Am J Hypertens. 2024 Mar 30:hpae035. doi: 10.1093/ajh/hpae035. Online ahead of print.

Authors

Nikit Venishetty¹, Jarett D Berry², James A de Lemos³, Elaine Wu³, Min Jae Lee⁴, Paul E Drawz⁵, Vijay Nambi^{6

7}, Christie M Ballantyne⁶, Anthony A Killeen⁸, Joachim H Ix^{9

10}, Michael G Shlipak¹¹, Simon B Ascher^{11

12}

Affiliations

¹ Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center, El Paso, TX.
² Department of Internal Medicine, University of Texas at Tyler Health Science Center, Tyler, TX.
³ Department of Cardiology, Division of Cardiology, the University of Texas at Southwestern Medical School, Dallas, TX.
⁴ Peter O'Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center, Dallas, TX.
⁵ Division of Nephrology and Hypertension, University of Minnesota Medical School, Minneapolis, MN.
⁶ Department of Medicine and Center for Cardiometabolic Disease Prevention, Baylor College of Medicine, Houston, TX.
⁷ Department of Medicine, Michael E. DeBakey Veterans Affairs Medical Center, Houston, TX.
⁸ Department of Laboratory Medicine and Pathology, University of Minnesota Medical School.
⁹ Nephrology Section, Veterans Affairs San Diego Healthcare System, San Diego, CA.
¹⁰ Division of Nephrology-Hypertension, University of California San Diego, San Diego, CA.
¹¹ Kidney Health Research Collaborative, San Francisco Veterans Affairs Health Care System and UCSF, San Francisco, CA.
¹² Division of Hospital Medicine, University of California Davis, Sacramento, CA.

PMID: 38554284
DOI: 10.1093/ajh/hpae035

Abstract

Background: Nighttime blood pressure (BP) has greater prognostic importance for cardiovascular disease (CVD) than daytime BP, but less is known about nighttime and daytime BP associations with measures of subclinical CVD.

Methods: Among 897 Systolic Blood Pressure Intervention Trial Study (SPRINT) participants with 24-hour ambulatory BP monitoring obtained near the 27-month study visit, 849 (95%) had N-terminal pro-B-type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hs-cTnT) measured at the 24-month study visit. Multivariable linear regression analyses were performed to evaluate the associations of nighttime and daytime BP with cardiac biomarker levels.

Results: Mean age was 69 ±12 years, 28% were African American, and mean nighttime and daytime SBP were 121 ±16 mm Hg and 132 ±14 mm Hg, respectively. In multivariable models, compared with the lowest tertile of nighttime systolic BP, the highest tertile was associated with 48% higher NT-proBNP levels (adjusted geometric mean ratio [GMR] = 1.48, 95% CI: 1.22, 1.79), and 19% higher hs-cTnT levels (adjusted GMR = 1.19, 95% CI: 1.07, 1.32). In contrast, the highest versus lowest tertile of daytime systolic BP was not associated with NT-proBNP (adjusted GMR = 1.09, 95% CI: 0.88, 1.34) but was associated with 16% higher hs-cTnT levels (adjusted GMR = 1.16, 95% CI: 1.04, 1.30). Similar results were observed using diastolic BP.

Conclusion: In SPRINT, both higher nighttime and daytime BP were independently associated with higher hs-cTnT levels, but only higher nighttime BP was associated with higher NT-proBNP levels.

Keywords: SPRINT; ambulatory blood pressure; natriuretic peptide; nocturnal hypertension; troponin.