{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T23:14:46Z","timestamp":1793747686310,"version":"4.6.1"},"reference-count":12,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T00:00:00Z","timestamp":1767830400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To evaluate whether circulating N-terminal pro-B type natriuretic peptide (NT-proBNP) and high-sensitivity cardiac troponin T (hsTnT) can stage hypertensive heart disease (HHD), by assessing their association with adverse cardiac remodelling and cardiovascular outcomes in individuals with essential hypertension.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p>The REMODEL study prospectively enrolled 1054 asymptomatic individuals with essential hypertension and no prior cardiovascular diseases (59 \u00b1 11 years old; systolic blood pressure 131 \u00b1 14\u2005mmHg; left ventricular ejection fraction 60 \u00b1 7%). All participants underwent cardiovascular magnetic resonance (CMR) and blood sampling for NT-proBNP and hsTnT. The primary outcome was a composite of acute coronary syndromes, heart failure hospitalization, stroke and all-cause mortality. Median follow-up was 53 (23, 72) months. Maximal log-rank statistic identified thresholds of 152\u2005pg\/ml for NT-proBNP and 12.7\u2005pg\/ml for hsTnT. Individuals with elevations in both biomarkers (high-risk) were older, had the highest 24-h systolic blood pressure and more diabetes mellitus. They showed the most adverse CMR phenotype, with increased myocardial mass, greater diffuse and replacement fibrosis, impaired left ventricular strain and higher left atrial volumes. Event rates differed significantly across biomarker strata (log-rank P &amp;lt; .001). High-risk individuals had the greatest hazard of cardiovascular events [hazard ratio (HR) 17.11; 95% confidence interval (CI) 8.12\u201336.09), while intermediate-risk individuals showed intermediate risk (HR 3.44; 95% CI 1.71\u20136.94).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>NT-proBNP and hsTnT are complementary biomarkers that not only predict cardiovascular outcomes and but also reflect the severity of cardiac remodelling in HHD. Their combined use enables effective staging of disease severity and may support stage-specific management strategies in patients with hypertension.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejhf\/xuaf001","type":"journal-article","created":{"date-parts":[[2026,1,8]],"date-time":"2026-01-08T09:02:13Z","timestamp":1767862933000},"source":"Crossref","is-referenced-by-count":4,"title":["Role of natriuretic peptides and cardiac troponins in staging hypertensive heart disease: the REMODEL study"],"prefix":"10.1093","author":[{"given":"Ashley","family":"Sharp","sequence":"first","affiliation":[{"name":"School of Medicine, University of Dundee , Dundee ,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tar-Choon","family":"Aw","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Changi General Hospital , Singapore 529889 ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thu-Thao","family":"Le","sequence":"additional","affiliation":[{"name":"National Heart Research Institute of Singapore, National Heart Centre Singapore , Singapore 169609 ,","place":["Singapore"]},{"name":"Cardiovascular Medicine Academic Clinical Program (ACP), Duke-NUS Medical School , Singapore 169609 ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Soon-Kieng","family":"Phua","sequence":"additional","affiliation":[{"name":"Department of Laboratory Medicine, Changi General Hospital , Singapore 529889 ,","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A Mark","family":"Richards","sequence":"additional","affiliation":[{"name":"Christchurch Heart Institute, University of Otago , Christchurch ,","place":["New Zealand"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"B\u00f6hm","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Innere Medizin III and HOMICAREM-Homburg Institute for CardioRenalMetabolic Medicine, Universit\u00e4tsklinikum des Saarlandes, Saarland University , Homburg\/Saar ,","place":["Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3414-6919","authenticated-orcid":false,"given":"Javier","family":"D\u00edez","sequence":"additional","affiliation":[{"name":"Program of Cardiovascular Diseases, Center of Applied Medical Research and School of Medicine, University of Navarra , Pamplona ,","place":["Spain"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4267-6933","authenticated-orcid":false,"given":"Javed","family":"Butler","sequence":"additional","affiliation":[{"name":"Baylor Scott and White Research Institute , Dallas, TX 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