Key result
Participants in the top quartile of baseline D-dimer had a higher risk of incident hypertension compared to the bottom quartile (RR 1.47; 95% CI 1.23-1.76), an association that did not differ by race.
Why the study?
Reasons for increased risk of hypertension in Black compared with White people are partly understood, and the impact of D-dimer on racial disparities in incident hypertension risk has not been studied.
Does higher baseline D-dimer increase the risk of incident hypertension in adults without baseline hypertension?
Cohort (n=1,867)
Yes
Does higher baseline D-dimer increase the risk of incident hypertension in adults without baseline hypertension?
Relative Risk: 1.47 (95% CI 1.23–1.76)
Higher baseline D-dimer concentrations are associated with an increased risk of incident hypertension, though this does not explain racial disparities in hypertension risk.
Higher D-dimer may flag elevated hypertension risk; leaves open causal role and utility for risk stratification.
Background: Reasons for increased risk of hypertension in Black compared with White people are only partly understood. D-dimer, a thrombo-inflammatory marker higher in Black individuals, is also higher in people with hypertension. However, the impact of D-dimer on racial disparities in risk of incident hypertension has not been studied. Objectives: To assess whether D-dimer is associated with the risk of incident hypertension, whether the association between D-dimer and the risk of incident hypertension differs by race, and whether the biology reflected by D-dimer explains racial disparities in the risk of incident hypertension. Methods: This study included 1867 participants in the REasons for Geographic And Racial Differences in Stroke cohort study without baseline hypertension and with a second visit 9.4 years after baseline. Risk ratios of incident hypertension by baseline D-dimer level were estimated, a D-dimer-by-race interaction was tested, and the mediating effect of D-dimer (which represents underlying biological processes) on the association of race and hypertension risk was assessed. Results: The risk of incident hypertension was 47% higher in persons in the top quartile than in those in the bottom quartile of D-dimer (risk ratio [RR]: 1.47; 95% CI: 1.23-1.76). The association was partly attenuated after adjusting for sociodemographic and adiposity-related risk factors (RR: 1.22; 95% CI: 1.02-1.47). The association of D-dimer and hypertension did not differ by race, and D-dimer did not attenuate the racial difference in the risk of incident hypertension. Conclusion: D-dimer concentration reflects pathophysiology related to the development of hypertension. Specific mechanisms require further study and may involve adiposity.
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Mukaz et al. (2023) conducted a cohort in Hypertension (n=1,867). Baseline D-dimer level (top quartile) vs. Bottom quartile of D-dimer was evaluated on Incident hypertension (RR 1.47, 95% CI 1.23-1.76). Participants in the top quartile of baseline D-dimer had a higher risk of incident hypertension compared to the bottom quartile (RR 1.47; 95% CI 1.23-1.76), an association that did not differ by race.
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