Myocardial damage may predict hypertension development in normotensive individuals
Individuals with normal blood pressure (BP) levels who present with subclinical myocardial damage are highly likely to develop subsequent hypertension, a recent study suggests.
Researchers examined 524 normotensive individuals (mean age 58 years; 53 percent female) without prior cardiovascular diseases at baseline. They evaluated ongoing myocardial damage by measuring the biomarker heart-type fatty acid binding protein (H-FABP) and assessed longitudinal changes in BP over a median follow-up period of 6.2 years.
There were 177 individuals (34 percent) who developed hypertension during the follow-up. On multivariate Cox proportional hazard analysis controlled for potential confounders such as age and baseline BP, presence of myocardial damage was significantly associated with an increased risk of developing hypertension (hazard ratio, 1.80; 95 percent CI, 1.26–2.54; p=0.0014).
Moreover, the relative risk of incident hypertension associated with myocardial damage was higher among younger individuals and for the lower BP category.
Researchers enumerated several possible reasons why preceding myocardial damage predicts future development of hypertension. First, the presence of myocardial damage in individuals with normal BP may originate from the underlying central haemodynamic stress, which is undetectable by brachial BP. Second, myocardial damage reflects the presence of masked hypertension at baseline in apparently normotensive individuals, and the said hypertension may become sustained during follow-up.
The present data suggest that individuals with normal blood pressure but with myocardial damage may be required further screening to detect hypertension, which can in turn reduce future healthcare costs by preventing cardiovascular diseases, researchers said.
“Therefore, further studies are required to determine in whom myocardial damage should be assessed to maximize the cost-effectiveness,” they added.