High-sensitivity troponin I in patients with arterial hypertension

BACKGROUND: The literature provides data on the mechanisms of increasing levels of high-sensitivity cardiac troponin (hs-cTn) in the absence of cardiomyocyte death, including in hypertension, and the causes are currently not thoroughly examined.

AIM: This study aimed to establish the factors associated with changes in hs-cTn level in patients with the initial stages of hypertension.

MATERIALS AND METHODS: The study included 43 patients with arterial hypertension from February 1 to April 1, 2023. All the included patients underwent a standard clinical and instrumental examination, and the concentrations of hs-cTn I and the N-terminal fragment of the precursor of the cerebral natriuretic peptide were determined. A predictive model of the probability of determining the hs-sTp I level above the reference values was constructed using the logistic regression method. The differences were considered significant at p <0.05.

RESULTS: The hs-sTp I level was >0.1 ng/mL in 29 patients, and the median, minimum, and maximum levels in all patients were 0.17 [0.10; 0.22], 0.07 , and 0.36 ng/mL, respectively. The predictor of changes in hs-sTp I level above the reference values was creatinine, with an odds ratio of 1.071 (95% confidence interval (CI) 1.003–1.145, p=0.041), and the predictor of finding the hs-sTp I level within the reference was the number of antihypertensive drugs taken: an increase in the “number of antihypertensive drugs” when determining the concentration of hs-sTp I above the norm decreased by 3.336 times (95% CI 0.105–0.854, p=0.024).

CONCLUSION: This pilot prospective study of patients with stage 1 and 2 hypertension demonstrated an association between an increase in serum creatinine and an increase in hs-sTp I levels and between the number of antihypertensive medications taken by the patient and a decrease in hs-sTp I levels. The results must be confirmed by a longitudinal prospective study of a large sample of patients, and the relationship of the data obtained with short- and long-term prognosis in people with hypertension must be determined.