Background: Soluble ST2 (sST2) is an emerging prognostic biomarker in patients with existing cardiovascular disease. ST2 and its ligand, interleukin-33 (IL-33), are expressed in endothelial cells, and may play an important role in the development of early atherosclerosis and vascular biology. We sought to investigate the association of sST2 and progression of blood pressure (BP), as well as the development of hypertension.
Methods: Circulating sST2 concentrations were measured in 1834 participants (mean age 56 years, 57% women) of the community-based Framingham Offspring study. Participants were free of hypertension at baseline. Multivariable linear and logistic regression models were used to evaluate the association of sST2 concentrations and subsequent BP outcomes.
Results: Higher sST2 concentrations were associated with incident hypertension over 3 years of follow-up [multivariable-adjusted odds ratio per 1 standard deviation increase in sST2 1.22, 95% confidence interval 1.05–1.42, P = 0.01]. Individuals in the upper sST2 quartile had a 2.6 mmHg greater increase in SBP compared with those in the lowest quartile (P for trend across quartiles 0.002) and a 1.8 mmHg greater increase in pulse pressure (P for trend 0.005). In contrast, sST2 concentrations were not associated with changes in DBP (P = 0.27).
Conclusion: These findings suggest that sST2 concentrations predict changes in BP physiology typically seen with aging and progressive arterial stiffness. Further studies are needed to elucidate underlying mechanisms by which the ST2/IL-33 pathway may contribute to BP physiology.
aFramingham Heart Study of the National Heart, Lung and Blood Institute and Boston University School of Medicine, Framingham
bCardiovascular Medicine Section, Department of Medicine
cDepartment of Mathematics and Statistics, Boston University
dCardiology Division, Department of Medicine, Massachusetts General Hospital
eDivision of Cardiology, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School
fCardiology and Preventive Medicine, Department of Medicine, Boston University School of Medicine
gCardiovascular Research Center, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
Correspondence to James L. Januzzi Jr, MD, Cardiology Division, Massachusetts General Hospital, Yawkey 5984, 32 Fruit Street, Boston, MA 02114, USA. Tel: +1 617 724 6750; fax: +1 617 643 1620; e-mail: firstname.lastname@example.org
Abbreviations: BP, blood pressure; CI, confidence interval; eGFR, estimated glomerular filtration rate; FHS, Framingham Heart Study; OR, odds ratio; sST2, soluble ST2
Received 5 November, 2012
Revised 2 January, 2013
Accepted 11 March, 2013
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