Jagodzinski Annika, Neumann Johannes Tobias, Ojeda Francisco, Sörensen Nils Arne, Wild Philipp, Münzel Thomas, Zeller Tanja, Westermann Dirk, Blankenberg Stefan
Department of General and Interventional Cardiology, University Heart Center Hamburg, Hamburg, Germany.
German Center for Cardiovascular Research, Partner Site Hamburg/Kiel/Lübeck, Hamburg, Germany.
Clin Chem. 2017 Dec;63(12):1877-1885. doi: 10.1373/clinchem.2017.275289. Epub 2017 Sep 13.
High blood pressure (BP) is associated with an increased rate of cardiovascular events and mortality. Cardiovascular biomarkers are able to predict long-term risk in the general population, particularly in diseased cohorts. We undertook an investigation of the effect of 2 different antihypertensive treatments on cardiovascular biomarkers in a randomized trial.
The TEAMSTA study included 481 hypertensive patients. They were randomized to either 80-mg telmisartan + 5-mg amlodipine (TA) or 40-mg olmesartan + 12.5-mg hydrochlorothiazide (OH). The trial was performed as a prospective, randomized, double-blinded, controlled, single-center study. We measured BP, high-sensitivity cardiac troponin I (hs-cTnI), high-sensitivity cardiac troponin T (hs-cTnT), B-type natriuretic peptide (BNP), and N-terminal-pro-BNP (NT-proBNP) before randomization and after 6 months.
Individuals were randomized into 2 groups: 230 individuals to the OH-group and 251 to the TA-group. After 6 months of treatment, a reduction in BP (systolic/diastolic) was seen, from 135.2/85.2 mmHg to 122.5/75.7 mmHg with similar effects in both groups. hs-cTnT concentrations were measureable in 26.2% of the study population, while hs-cTnI was detected in 98.3%. hs-cTnI concentrations were significantly reduced from 4.6 to 4.2 ng/L in the overall population, from 4.7 to 4.4 ng/L in the OH-group, and from 4.6 to 4.0 ng/L in the TA-group (all < 0.001). No significant changes of hs-cTnT were observed. BNP and NT-proBNP concentrations decreased from 15.0 to 12.4 ng/L ( < 0.001) and from 64.8 to 53.3 ng/L ( < 0.001), respectively, after 6 months.
The reduction in BP was associated with a decrease of high-sensitivity troponin I, BNP, and NT-proBNP concentrations, which might represent a cardiovascular risk reduction.
EudraCT 2009-017010-68.
高血压与心血管事件发生率及死亡率的增加相关。心血管生物标志物能够预测普通人群，尤其是患病群体的长期风险。我们在一项随机试验中研究了两种不同的降压治疗对心血管生物标志物的影响。
TEAMSTA研究纳入了481例高血压患者。他们被随机分为80毫克替米沙坦+5毫克氨氯地平（TA）组或40毫克奥美沙坦+12.5毫克氢氯噻嗪（OH）组。该试验作为一项前瞻性、随机、双盲、对照、单中心研究进行。我们在随机分组前和6个月后测量了血压、高敏心肌肌钙蛋白I（hs-cTnI）、高敏心肌肌钙蛋白T（hs-cTnT）、B型利钠肽（BNP）和N末端B型利钠肽原（NT-proBNP）。
个体被随机分为两组：230例个体进入OH组，251例进入TA组。治疗6个月后，血压（收缩压/舒张压）出现下降，从135.2/85.2毫米汞柱降至122.5/75.7毫米汞柱，两组效果相似。26.2%的研究人群可检测到hs-cTnT浓度，而98.3%的人群检测到hs-cTnI浓度。总体人群中hs-cTnI浓度从4.6纳克/升显著降至4.2纳克/升，OH组从4.7纳克/升降至4.4纳克/升，TA组从4.6纳克/升降至4.0纳克/升（均<0.001）。未观察到hs-cTnT有显著变化。6个月后，BNP和NT-proBNP浓度分别从15.0纳克/升降至12.4纳克/升（<0.001）和从64.8纳克/升降至53.3纳克/升（<0.001）。
血压降低与高敏肌钙蛋白I、BNP和NT-proBNP浓度降低相关，这可能代表心血管风险降低。
EudraCT 2009-017010-68。
