Hypertension outweighs heart stress as a predictor of heart failure risk according to the prevent-hf score. EHUH2 study

Introduction Heart stress (HS) is an emerging condition defined as increased NT-proBNP in patients with risk factors such as hypertension (HT). Purpose The study aimed to determine if the presence of HS leads to a higher risk of developing heart failure (HF) as predicted by the PREVENT-HF model and higher cardiovascular disease (CVD) risk as predicted by SCORE2 and PREVENT models. Methods This study employed a cross-sectional design within the framework of the nationwide EH-UH 2 project, utilizing a representative random sample of noninstitutionalized adults aged 18 years and older. In this analysis, we included 815 participants (mean age 59 years; 39.3% male). HS is defined as NT-proBNP levels of at least 75 pg/mL for participants younger than 50, at least 150 pg/mL for those aged 50 to 74, and at least 300 pg/mL for participants 75 years or older. Blood pressure was assessed according to ESH guidelines, with hypertension defined as either a blood pressure exceeding 140/90 mmHg or current use of antihypertensive medication. Risk assessments were performed with the SCORE2/SCORE2-OP, PREVENT, and PREVENT-HF models. Risk scores were evaluated across four groups, categorized by their HT and HS status: group A (HT- HS-), group B (HT+ HS-), group C (HT- HS+), and group D (HT+ HS+). Results All three risk scores were the lowest in group A, subjects without HS and HT, and were the highest in group D, those with HS and HT (table). Group B, HT subjects without HS had significantly higher PREVENT and, interestingly, PREVENT-HF risks than group C, HS subjects without HT (table and figure).Table 1Figure 1