Associations of Ambulatory Blood Pressure Measurements With High-Sensitivity Troponin and Natriuretic Peptide Levels in SPRINT

Author:

Venishetty Nikit1ORCID,Berry Jarett D2,de Lemos James A3,Wu Elaine3,Lee MinJae4,Drawz Paul E5,Nambi Vijay67,Ballantyne Christie M6,Killeen Anthony A8,Ix Joachim H910,Shlipak Michael G11,Ascher Simon B1112ORCID

Affiliation:

1. Department of Medicine, Paul L. Foster School of Medicine, Texas Tech University Health Sciences Center , El Paso, Texas , USA

2. Department of Medicine, University of Texas at Tyler Health Science Center , Tyler, Texas , USA

3. Division of Cardiology, Department of Cardiology, the University of Texas at Southwestern Medical School , Dallas, Texas , USA

4. Department of Biostatistics, Peter O’Donnell Jr. School of Public Health, University of Texas Southwestern Medical Center , Dallas, Texas , USA

5. Division of Nephrology and Hypertension, University of Minnesota Medical School , Minneapolis, Minnesota , USA

6. Department of Medicine and Center for Cardiometabolic Disease Prevention, Baylor College of Medicine , Houston, Texas , USA

7. Department of Medicine, Michael E. DeBakey Veterans Affairs Medical Center , Houston, Texas , USA

8. Department of Laboratory Medicine and Pathology, University of Minnesota Medical School , Minneapolis, Minnesota , USA

9. Nephrology Section, Veterans Affairs San Diego Healthcare System , San Diego, California , USA

10. Division of Nephrology-Hypertension, University of California San Diego , San Diego, California , USA

11. Department of Medicine, Kidney Health Research Collaborative, San Francisco Veterans Affairs Health Care System and University of California San Francisco , San Francisco, California , USA

12. Division of Hospital Medicine, University of California Davis , Sacramento, California , USA

Abstract

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 The 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 vs. 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. CONCLUSIONS 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.

Funder

National Heart, Lung, and Blood Institute

National Center for Advancing Translational Sciences

National Institutes of Health

American Heart Association

National Institute of Diabetes and Digestive and Kidney Diseases

National Institute on Aging

National Institute of Neurological Disorders and Stroke

Publisher

Oxford University Press (OUP)

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