Cross sectionally, inflammation has been associated with subclinical wall remodeling and hypertension in Black men. Whether longitudinal changes in inflammation and myocyte injury (troponin T) and stretch (N-terminal-pro-B-type natriuretic peptide) are associated with hypertension and ECG left ventricular hypertrophy (ECG-LVH), are unclear.
We therefore investigated these associations in a Black and White teachers’ cohort (N = 338; aged 20–65 years) utilizing a prospective approach. Fasting blood samples were obtained to measure tumor necrosis factor-alpha (TNF-α), cardiac troponin T (cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP). Ambulatory blood pressure, -2-lead ECG and resting 10-lead ECG values were obtained.
In Blacks a higher mean hypertensive status (62%) was evident compared to Whites (44%, p = 0.007). NT-proBNP increased in both ethnic groups. CRP revealed no changes in Black and White men while TNF-α decreased (p = 0.02) in Black men only. White men showed decreases in cTnT and increases in ECG-LVH over 3 years (p < 0.001). No associations were found between ECG-LVH and any other risk markers in the bi-ethnic cohort. In Black men, ΔNT-proBNP was associated with ΔcTnT (Adj R2 0.25; β = 0.29 95% CI 0.06 to 0.53, p = 0.02), ΔTNF-α (Adj R2 0.25; β = −0.24; 95% CI −0.46 to −0.03, p = 0.03 and Δ24-hour systolic blood pressure (Adj R2 0.25; β = 0.39; 95% CI 0.17 to 0.62, p = 0.001). ΔNT-proBNP (OR = 0.97, 95% CI 0.95 to 1.00, p = 0.02) predicted 24-hour systolic hypertension in Black men.
Chronic levels of raised myocyte injury accompanied by progressive myocardial stretch, reflective of cardiac metabolic over-demand, may ultimately increase hypertension and ischemic heart disease risk in a Black male cohort.
1Hypertension in Africa Research Team (HART) North-West University South Africa
2Consultation-Liaison Psychiatry and Psychosomatic Medicine University Hospital Zurich Switzerland