Institutional members access full text with Ovid®

Soluble ST2 predicts elevated SBP in the community

Ho, Jennifer E.a,b; Larson, Martin G.a,c; Ghorbani, Anahitad; Cheng, Susana,e; Vasan, Ramachandran S.a,f; Wang, Thomas J.a,d,g; Januzzi, James L. Jrd

doi: 10.1097/HJH.0b013e3283611bdf

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:

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

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal's Website (

© 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins