Why the study?
Although cardiac biomarkers are well established in heart failure, little was known about the prognostic significance of routine natriuretic peptides and cardiac troponins in hypertensive patients when heart failure is excluded.
Do elevated routine cardiac biomarkers (natriuretic peptides and cardiac troponins) predict 5-year incident major adverse cardiac events in hypertensive patients without heart failure?
Cohort
Yes
Do elevated routine cardiac biomarkers (natriuretic peptides and cardiac troponins) predict 5-year incident major adverse cardiac events in hypertensive patients without heart failure?
In hypertensive patients without heart failure, elevated routine natriuretic peptides and cardiac troponins independently identify patients at significantly higher 5-year risk of MACE and all-cause mortality.
Answers are grounded in this paper and cite their sources.
NT-proBNP elevation signals higher MACE risk; extends biomarker prognostication beyond HF yet leaves clinical adoption open.
The use of biomarkers in heart failure (HF) is long established; however, little is known about the prognostic significance of these biomarkers in hypertension when HF has been excluded. This study examined the prognostic significance of routine cardiac biomarkers (natriuretic peptides and cardiac troponins) in hypertensive patients when HF has been excluded. We analyzed electronic medical records from a global federated research network TriNetX. Cohorts were built based on biomarker-specific thresholds with 1:1 propensity-score matching. Cox proportional models were used to estimate hazard ratios with 95% confidence interval for 5-year incident major adverse cardiac events (MACE). Our analysis identified four biomarker cohorts: (a) B-type natriuretic peptide (BNP)-80,740 patients (b) N-terminal pro B-type natriuretic peptide (NT-proBNP)-46,164 patients (c) cardiac troponin T-13,785 patients, and (d) cardiac troponin I-183,346. Elevated NT-proBNP had an increased risk for MACE (HR 1.9, 95% CI 1.86, 1.96 p < 0.0001) and all-cause mortality (HR 2.13 95% CI 95% CI 2.07, 2.18 p < 0.0001) compared to those with lower levels. Similarly, hs-cTnT showed significant association with MACE (HR 1.53 95% CI 1.46, 1.61 p < 0.0001). Elevated natriuretic peptides and cardiac troponins in hypertensive patients without HF demonstrate significant risk of MACE and its individual components.
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Mbeta et al. (2026) conducted a cohort in Hypertension without heart failure. Elevated routine cardiac biomarkers (BNP, NT-proBNP, cardiac troponin T, cardiac troponin I) vs. Lower cardiac biomarker levels (1:1 propensity-score matched) was evaluated on 5-year incident major adverse cardiac events (MACE) (HR 1.9, 95% CI 1.86-1.96, p=<0.0001).
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