Year: 2024
Type: article
Abstract: BACKGROUND: Hs-cTnT (cardiac troponin T measured with a highly sensitive assay) and NT-proBNP (N-terminal pro-B-type natriuretic peptide) may identify adults with hypertension who derive greater cognitive benefits from lower systolic blood pressure targets. METHODS: In the SPRINT (Systolic Blood Pressure Intervention Trial) MIND study, participants were categorized as having both hs-cTnT and NT-proBNP in the lower 2 tertiles (n=4226), one in the highest tertile (n=2379), and both in the highest tertile (n=1506). We assessed the effect of intensive versus standard treatment on the composite of mild cognitive impairment (MCI) or probable dementia (PD) across biomarker categories. RESULTS: Over a median follow-up of 5.1 years, 830 of 8111 participants (10.2%) developed MCI or PD. Participants in the highest biomarker category were at higher risk of MCI or PD compared with those in the lowest category (hazard ratio, 1.34 [95% CI, 1.00–1.56]). The effect of intensive treatment on reducing the risk of MCI or PD was greater among participants in the lowest biomarker category (hazard ratio, 0.64 [95% CI, 0.50–0.81]) than those in the intermediate (hazard ratio, 1.01 [95% CI, 0.80–1.28]) or highest categories (hazard ratio, 0.90 [95% CI, 0.72–1.13]; P interaction =0.02). The 5-year absolute risk differences in MCI or PD with intensive treatment were −2.9% (−4.4%, −1.3%), −0.2% (−3.0%, 2.6%), and −1.9% (−6.2%, 2.4%) in the lowest, intermediate, and highest biomarker categories, respectively. CONCLUSIONS: In SPRINT, the relative effect of intensive systolic blood pressure lowering on preventing cognitive impairment appears to be stronger among participants with lower compared with higher cardiac biomarker levels, though the absolute risk reductions were similar.
Source: Hypertension
Institutions: The University of Texas at Tyler, The University of Texas Health Science Center at Tyler, Harvard University, Wake Forest University, The University of Texas Southwestern Medical Center, Wake Forest University Health Sciences, Baylor College of Medicine, Michael E. DeBakey VA Medical Center, University of Glasgow, University of Minnesota, University of California San Diego, VA San Diego Healthcare System, University of California, San Francisco, San Francisco VA Health Care System, University of California Davis Medical Center, University of California, Davis
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: green
Funders: U.S. Department of Veterans Affairs, American Heart Association, University of California, Vanderbilt University, University of Pennsylvania, George Washington University, Wake Forest University, Tulane University, University of Texas Southwestern Medical Center, University of Pittsburgh, Case Western Reserve University, National Institutes of Health, University of Illinois at Urbana-Champaign, Takeda Pharmaceuticals International, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute of General Medical Sciences, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Neurological Disorders and Stroke, National Center for Research Resources, National Center for Advancing Translational Sciences
Awards: G1037376802, G1108988672, G1182793083, G1201304535, G1271685901, G1288625085, G1294028474, G1304405445, G130883262, G1346455397, G1425514332, G1452718737, G1534123016, G156123175, G1575401839, G1638468373, G1815451664, G1870882027, G2280939255, G2301334622, The Ohio State University Center for Clinical and Translational Science (UL1), G2499961, Deuterated Analogs of Praziquantel for Treatment of Schistosomiasis, G256492535, G2573152475, G2693036755, G2759730755, G2826625206, G2866321202, G3042542605, G3073611831, G3152898467, G3272238124, G3340927746, G3370453791, G3604805317, G3658248675, G370977179, Translational Research in Hypertension and Renal Biology, G3759862710, G3866621487, G3884610240, G397302370, G4018866504, Clinical and Translational Science Institute at Children's National, UF Clinical and Translational Science Award, G4245472998, G4425699080, G4645810025, G4823677270, G4949749077, G49760422, SPRINT MIND 2020, G5068655555, G5144704047, G5185313375, G522538789, G5253921404, G5256763093, G5473830807, G5497268829, G5500374692, G5608407112, G5642491254, G5679716143, G576625284, G5773225010, G5831220822, Tufts Clinical and Translation Science Institute (UL1), G5971433106, G6330340713, G644558944, G6727567258, G6760263438, G67735801, University of Pittsburgh Clinical and Translational Science Institute, G6948654770, G7041822434, G709749280, G728281721, G742032275, G7620386198, G7638611195, G7738083902, The Vanderbilt Institute for Clinical and Translational Research (VICTR), G7798204357, G8004166952, G8095131, G8450174239, G847355820, G8624175963, G8723760441, G8762501422, G884570035, G8904682394, Incorporating Patient Outcome Preferences into Personalized Blood Pressure Target Decisions, G8985239187, G9000016349, G9000025022, G9000033427, G9000036510, G9000037440, G9000038858, G9000044334, G9000053383, G9000088048, G9000089129, G9000111155, G9000111834, G9000123801, G9000127828, G9000185220, G9000235735, G9000349900, UT Southwestern NORC, Institutional Career Development Core (KL2), G94668252
OpenAlex ID: W4400295452