Heart stress was present in 26.1% of adults and identified a phenotype characterized by vascular aging, subclinical cardiac injury, impaired kidney function, and increased cardiovascular risk.
Cross-Sectional (n=1,198)
Yes
Heart stress, defined by elevated NT-proBNP within the normal range, is common in the general adult population and identifies individuals with subclinical cardiovascular and renal dysfunction.
Objective: Heart stress (HS) indicates that elevated NT-proBNP values within the normal range can be related to poorer outcome. The objective of this study was to examine the prevalence and characteristics of HS in general adult population. Design and method: This cross-sectional analysis included 1198 non-institutionalized adults aged over 18 from the nationwide EH-UH2 project (27.8% men). HS was defined according to age-specific NT-proBNP cutoffs: 75 pg/mL (<50 years), 150 pg/mL (50–74 years), and 300 pg/mL (75+ years). Participants were grouped as HS (N=313) and non-HS (N=885). SCORE2/OP2, PREVENT, PREVENT-HF were calculated using recommended equations. Results: The prevalence of HS in this cohort was 26.1%. HS were older (p<0.001) and more often women (p=0.002). HS was less prevalent among normotensive subjects and in subjects with controlled hypertension (HT) vs. untreated and uncontrolled HT (25.1% vs. 22.6% vs. 28.7% vs. 29.1%, respectively; p=0.287). Diabetes (32.4%), atrial fibrillation (39.1%) and CKD (43.9%) occurred more often in HS. There were no differences in smoking status, however, HS had more pack years (p<0.001). HS had higher Na/K ratio and lower potassium intake (p=0.002) with no differences in salt consumption. There were no significant differences in BMI, waist circumference, ABSI and BP between groups. Central PP (p=0.018), AIx (p=0.034), and ePWV (p=0.004) were significantly higher in individuals with HS. We failed to find differences in lipid status, serum uric acid, HOMA and ACR but subjects with HS had higher values of fasting blood glucose, troponin I, but lower eGFR (all p<0.05). HS showed significantly higher SCORE 2, PREVENT-HF (all p<0.001), and PREVENT (p=0.007) scores than non-HS. In multivariate stepwise regression analyses (R2=0.89) significant predictors of HS were NT-proBNP, ePWV, female gender and status of untreated/uncontrolled HT. When we excluded NT proBNP from the model, the significant predictors were female gender, lower eGFR, LDL-cholesterol, Na/K ratio and high heart rate. Conclusions: HS is common among adults and identifies a phenotype characterized by vascular aging, subclinical cardiac injury, impaired kidney function and increased global cardiovascular risk, even in the absence of major differences in traditional risk factors.
Mandaric et al. (Fri,) conducted a cross-sectional in Heart stress (n=1,198). Heart stress vs. Non-heart stress was evaluated on Prevalence of heart stress. Heart stress was present in 26.1% of adults and identified a phenotype characterized by vascular aging, subclinical cardiac injury, impaired kidney function, and increased cardiovascular risk.