High-Sensitivity Troponin T, NT-proBNP, and Cognitive Outcomes in SPRINT.

Pubmed ID: 38957975

Pubmed Central ID: PMC11842154

Journal: Hypertension (Dallas, Tex. : 1979)

Publication Date: Sept. 1, 2024

MeSH Terms: Humans, Male, Female, Aged, Middle Aged, Hypertension, Blood Pressure, Follow-Up Studies, Antihypertensive Agents, Cognition, Peptide Fragments, Natriuretic Peptide, Brain, Dementia, Biomarkers, Troponin T, Cognitive Dysfunction

Grants: UL1 TR000445, UL1 TR000005, HHSN268200900040C, HHSN268200900046C, HHSN268200900047C, HHSN268200900048C, HHSN268200900049C, P30 GM103337, UL1 TR000433, UL1 TR000439, UL1 TR000002, UL1 TR001064, UL1 TR000064, UL1 TR000075, UL1 RR025752, UL1 RR025771, UL1 TR000093, UL1 TR000003, UL1 TR000050, UL1 TR000073, UL1 RR025755, UL1 TR000105, UL1 RR024134, UL1 TR001420, UL1 TR001860, R01 HL144112, KL2 TR001859, R01 AG055606

Authors: Pajewski NM, Shlipak MG, Zhang W, Ballantyne CM, Haney D, Berry JD, Sattar N, Soliman EZ, de Lemos JA, Killeen AA, Ix JH, Nambi V, Ma Y, Ascher SB, Dalmacy D, Hajjar I

Cite As: Haney D, Ma Y, Dalmacy D, Pajewski NM, Hajjar I, de Lemos JA, Zhang W, Soliman EZ, Ballantyne CM, Nambi V, Sattar N, Killeen AA, Ix JH, Shlipak MG, Berry JD, Ascher SB. High-Sensitivity Troponin T, NT-proBNP, and Cognitive Outcomes in SPRINT. Hypertension 2024 Sep;81(9):1956-1965. Epub 2024 Jul 3.

Studies:

Abstract

BACKGROUND: Hs-cTnT (cardiac troponin T measured with a highly sensitive assay) and NT-proBNP (N-terminal pro-B-type natriuretic peptide) may identify adults with hypertension who derive greater cognitive benefits from lower systolic blood pressure targets. METHODS: In the SPRINT (Systolic Blood Pressure Intervention Trial) MIND study, participants were categorized as having both hs-cTnT and NT-proBNP in the lower 2 tertiles (n=4226), one in the highest tertile (n=2379), and both in the highest tertile (n=1506). We assessed the effect of intensive versus standard treatment on the composite of mild cognitive impairment (MCI) or probable dementia (PD) across biomarker categories. RESULTS: Over a median follow-up of 5.1 years, 830 of 8111 participants (10.2%) developed MCI or PD. Participants in the highest biomarker category were at higher risk of MCI or PD compared with those in the lowest category (hazard ratio, 1.34 [95% CI, 1.00-1.56]). The effect of intensive treatment on reducing the risk of MCI or PD was greater among participants in the lowest biomarker category (hazard ratio, 0.64 [95% CI, 0.50-0.81]) than those in the intermediate (hazard ratio, 1.01 [95% CI, 0.80-1.28]) or highest categories (hazard ratio, 0.90 [95% CI, 0.72-1.13]; <i>P</i><sub>interaction</sub>=0.02). The 5-year absolute risk differences in MCI or PD with intensive treatment were -2.9% (-4.4%, -1.3%), -0.2% (-3.0%, 2.6%), and -1.9% (-6.2%, 2.4%) in the lowest, intermediate, and highest biomarker categories, respectively. CONCLUSIONS: In SPRINT, the relative effect of intensive systolic blood pressure lowering on preventing cognitive impairment appears to be stronger among participants with lower compared with higher cardiac biomarker levels, though the absolute risk reductions were similar.