{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T14:51:01Z","timestamp":1753887061775,"version":"3.41.2"},"reference-count":40,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"6","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2022,3,15]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Assessing the risk of serious adverse events (SAEs) during hypertension treatment is important for understanding the benefit\u2010harm trade\u2010offs of lower blood pressure goals. It is unknown whether high\u2010sensitivity cardiac troponin T (hs\u2010cTnT) and N\u2010terminal pro\u2010B\u2010type natriuretic peptide (NT\u2010proBNP) provide information about SAEs.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              In SPRINT (Systolic Blood Pressure Intervention Trial), hs\u2010cTnT and NT\u2010proBNP were measured at baseline in 8828 (94.3%) and 8836 (94.4%) participants, respectively. Multivariable Cox proportional hazards models were used to evaluate hs\u2010cTnT and NT\u2010proBNP associations with a composite of SPRINT\u2019s SAEs of interest: hypotension, syncope, bradycardia, acute kidney injury, electrolyte abnormalities, and injurious falls. Elevations in hs\u2010cTnT and NT\u2010proBNP were associated with increased composite SAE risk (hazard ratio [HR] per 2\u2010fold higher hs\u2010cTnT: 1.15; 95% CI, 1.06\u20121.25; HR per 2\u2010fold higher NT\u2010proBNP: 1.09; 95% CI, 1.05\u20121.14). Compared with both hs\u2010cTnT and NT\u2010proBNP in the lower tertiles, both biomarkers in the highest tertile was associated with increased composite SAE risk (HR, 1.56; 95% CI, 1.32\u20121.84). Composite SAE risk was higher in the intensive\u2010treatment group than in the standard\u2010treatment group for participants with both biomarkers in the lower tertiles, but similar between treatment groups for participants with both biomarkers in the highest tertile (\n              <jats:italic>P<\/jats:italic>\n              for interaction=0.008).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">Elevations in hs\u2010cTnT and NT\u2010proBNP individually and in combination are associated with higher composite SAE risk in SPRINT. The differential impact of blood pressure treatment on SAE risk across combined biomarker categories may have implications for identifying individuals with more favorable benefit\u2010harm profiles for intensive blood pressure lowering.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.121.023314","type":"journal-article","created":{"date-parts":[[2022,3,4]],"date-time":"2022-03-04T10:32:25Z","timestamp":1646389945000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":5,"title":["Associations of High\u2010Sensitivity Troponin and Natriuretic Peptide Levels With Serious Adverse Events in SPRINT"],"prefix":"10.1161","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3465-4208","authenticated-orcid":false,"given":"Simon B.","family":"Ascher","sequence":"first","affiliation":[{"name":"Department of Medicine Kidney Health Research CollaborativeSan Francisco Veterans Affairs Health Care System and University of California San Francisco San Francisco CA"},{"name":"Division of Hospital Medicine University of California Davis Sacramento CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca","family":"Scherzer","sequence":"additional","affiliation":[{"name":"Department of Medicine Kidney Health Research CollaborativeSan Francisco Veterans Affairs Health Care System and University of California San Francisco San Francisco CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jame A.","family":"de Lemos","sequence":"additional","affiliation":[{"name":"Divison of Cardiology Department of Internal Medicine University of Texas Southwestern Medical Center Dallas TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle M.","family":"Estrella","sequence":"additional","affiliation":[{"name":"Department of Medicine Kidney Health Research CollaborativeSan Francisco Veterans Affairs Health Care System and University of California San Francisco San Francisco CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasantha K.","family":"Jotwani","sequence":"additional","affiliation":[{"name":"Department of Medicine Kidney Health Research CollaborativeSan Francisco Veterans Affairs Health Care System and University of California San Francisco San Francisco CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6016-4715","authenticated-orcid":false,"given":"Pranav S.","family":"Garimella","sequence":"additional","affiliation":[{"name":"Division of Nephrology\u2010Hypertension University of California San Diego San Diego CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexander L.","family":"Bullen","sequence":"additional","affiliation":[{"name":"Division of Nephrology\u2010Hypertension University of California San Diego San Diego CA"},{"name":"Nephrology Section Veterans Affairs San Diego Healthcare System San Diego CA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Walter T.","family":"Ambrosius","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Data Science Wake Forest School of Medicine Winston\u2010Salem NC"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6432-1730","authenticated-orcid":false,"given":"Christie M.","family":"Ballantyne","sequence":"additional","affiliation":[{"name":"Department of Medicine and Center for Cardiometabolic Disease Prevention Baylor College of Medicine Houston TX"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4237-0267","authenticated-orcid":false,"given":"Vijay","family":"Nambi","sequence":"additional","affiliation":[{"name":"Department of Medicine and Center for Cardiometabolic Disease Prevention Baylor College of Medicine Houston TX"},{"name":"Department of Medicine Michael E. 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