Cardiovascular Biomarkers in Hypertensive Patients with Medical Treatment-Results from the Randomized TEAMSTA Protect I Trial

TY - JOUR

T1 - Cardiovascular Biomarkers in Hypertensive Patients with Medical Treatment-Results from the Randomized TEAMSTA Protect I Trial

AU - Jagodzinski, Annika

AU - Neumann, Johannes Tobias

AU - Ojeda, Francisco

AU - Sörensen, Nils Arne

AU - Wild, Philipp

AU - Münzel, Thomas

AU - Zeller, Tanja

AU - Westermann, Dirk

AU - Blankenberg, Stefan

N1 - © 2017 American Association for Clinical Chemistry.

PY - 2017/12

Y1 - 2017/12

N2 - BACKGROUND: High blood pressure (BP) is associated with an increased rate of cardiovascular events and mortality. Cardiovascular biomarkers are able to predict long-term risk in the general population, particularly in diseased cohorts. We undertook an investigation of the effect of 2 different antihypertensive treatments on cardiovascular biomarkers in a randomized trial.METHODS: The TEAMSTA study included 481 hypertensive patients. They were randomized to either 80-mg telmisartan + 5-mg amlodipine (TA) or 40-mg olmesartan + 12.5-mg hydrochlorothiazide (OH). The trial was performed as a prospective, randomized, double-blinded, controlled, single-center study. We measured BP, high-sensitivity cardiac troponin I (hs-cTnI), high-sensitivity cardiac troponin T (hs-cTnT), B-type natriuretic peptide (BNP), and N-terminal-pro-BNP (NT-proBNP) before randomization and after 6 months.RESULTS: Individuals were randomized into 2 groups: 230 individuals to the OH-group and 251 to the TA-group. After 6 months of treatment, a reduction in BP (systolic/diastolic) was seen, from 135.2/85.2 mmHg to 122.5/75.7 mmHg with similar effects in both groups. hs-cTnT concentrations were measureable in 26.2% of the study population, while hs-cTnI was detected in 98.3%. hs-cTnI concentrations were significantly reduced from 4.6 to 4.2 ng/L in the overall population, from 4.7 to 4.4 ng/L in the OH-group, and from 4.6 to 4.0 ng/L in the TA-group (all P < 0.001). No significant changes of hs-cTnT were observed. BNP and NT-proBNP concentrations decreased from 15.0 to 12.4 ng/L (P < 0.001) and from 64.8 to 53.3 ng/L (P < 0.001), respectively, after 6 months.CONCLUSIONS: The reduction in BP was associated with a decrease of high-sensitivity troponin I, BNP, and NT-proBNP concentrations, which might represent a cardiovascular risk reduction.CLINICAL TRIAL REGISTRATION: EudraCT 2009-017010-68.

AB - BACKGROUND: High blood pressure (BP) is associated with an increased rate of cardiovascular events and mortality. Cardiovascular biomarkers are able to predict long-term risk in the general population, particularly in diseased cohorts. We undertook an investigation of the effect of 2 different antihypertensive treatments on cardiovascular biomarkers in a randomized trial.METHODS: The TEAMSTA study included 481 hypertensive patients. They were randomized to either 80-mg telmisartan + 5-mg amlodipine (TA) or 40-mg olmesartan + 12.5-mg hydrochlorothiazide (OH). The trial was performed as a prospective, randomized, double-blinded, controlled, single-center study. We measured BP, high-sensitivity cardiac troponin I (hs-cTnI), high-sensitivity cardiac troponin T (hs-cTnT), B-type natriuretic peptide (BNP), and N-terminal-pro-BNP (NT-proBNP) before randomization and after 6 months.RESULTS: Individuals were randomized into 2 groups: 230 individuals to the OH-group and 251 to the TA-group. After 6 months of treatment, a reduction in BP (systolic/diastolic) was seen, from 135.2/85.2 mmHg to 122.5/75.7 mmHg with similar effects in both groups. hs-cTnT concentrations were measureable in 26.2% of the study population, while hs-cTnI was detected in 98.3%. hs-cTnI concentrations were significantly reduced from 4.6 to 4.2 ng/L in the overall population, from 4.7 to 4.4 ng/L in the OH-group, and from 4.6 to 4.0 ng/L in the TA-group (all P < 0.001). No significant changes of hs-cTnT were observed. BNP and NT-proBNP concentrations decreased from 15.0 to 12.4 ng/L (P < 0.001) and from 64.8 to 53.3 ng/L (P < 0.001), respectively, after 6 months.CONCLUSIONS: The reduction in BP was associated with a decrease of high-sensitivity troponin I, BNP, and NT-proBNP concentrations, which might represent a cardiovascular risk reduction.CLINICAL TRIAL REGISTRATION: EudraCT 2009-017010-68.

KW - Aged

KW - Amlodipine/therapeutic use

KW - Antihypertensive Agents/therapeutic use

KW - Benzimidazoles/therapeutic use

KW - Benzoates/therapeutic use

KW - Biomarkers/blood

KW - Blood Pressure/drug effects

KW - Female

KW - Humans

KW - Hydrochlorothiazide/therapeutic use

KW - Hypertension/blood

KW - Imidazoles/therapeutic use

KW - Male

KW - Middle Aged

KW - Natriuretic Peptide, Brain/blood

KW - Peptide Fragments/blood

KW - Prospective Studies

KW - Telmisartan

KW - Tetrazoles/therapeutic use

KW - Treatment Outcome

KW - Troponin I/blood

KW - Troponin T/blood

U2 - 10.1373/clinchem.2017.275289

DO - 10.1373/clinchem.2017.275289

M3 - SCORING: Journal article

C2 - 28904053

VL - 63

SP - 1877

EP - 1885

JO - CLIN CHEM

JF - CLIN CHEM

SN - 0009-9147

IS - 12

ER -