J Clin Med Res

Journal of Clinical Medicine Research, ISSN 1918-3003 print, 1918-3011 online, Open Access

Article copyright, the authors; Journal compilation copyright, J Clin Med Res and Elmer Press Inc

Journal website https://www.jocmr.org

Review

Volume 14, Number 11, November 2022, pages 448-457

Hypertension as One of the Main Non-Myocardial Infarction-Related Causes of Increased Cardiospecific Troponins: From Mechanisms to Significance in Current Medical Practice

Figure 1. Main reasons of MC injury and increased CTs levels in body fluids. MCs: myocardial cells; CT: cardiospecific troponin; COVID-19: coronavirus disease 2019.

Figure 2. Scheme of localization of the structural and cytoplasmic CTs fraction. CTs: cardiospecific troponins; C: troponin C; T: troponin T; I: troponin I; MC: myocardial cell.

Figure 3. Pathophysiological mechanisms of MC injury and increased CTs levels in body fluids in case of HT. CT: cardiospecific troponin; MC: myocardial cell.

**Table 1.** Clinical Studies on the Diagnostic Significance of CTs in Case of HT
No.	Number of patients, diagnosis	Biomaterials	Prevalence and degree of CTs increase in case of HT, predictive significance	References
^aIncreased/elevated level of CTs is a level exceeding the standard 99 percentile provided by the manufacturer of the immunotest. BP: blood pressure; CTs: cardiospecific troponins; CT-T: cardiospecific troponin T; CT-I: cardiospecific troponin I; HT: hypertension.
1	Primary HT, n = 306	Serum	Increased^a CT-T levels were observed in 47% of patients with high BP and were associated with left ventricular hypertrophy and poor long-term prognosis.	[52]
2	Primary HT, n = 20	Urine	CT-I levels in the urine of patients with high BP (HT) were significantly higher than in patients with normal BP. Reference intervals for CTs levels in the urine have not yet been established.	[54]
3	Primary HT, n = 467	Serum	Increased^a CT-I levels were observed in 15% of patients with high BP and were associated with the risk of chronic congestive cardiac failure.	[100]
4	Primary HT, n = 171	Serum	Increased^a CT-I levels were observed in 32% of patients with high BP and were associated with the increased risk of major adverse cardiac events (MACE) and the risk of coronary heart disease.	[101]
5	Primary HT, n = 929	Serum	Increased^a CT-I levels were observed in 31% of patients with high BP and were associated with the risk of myocardial infarction and pulmonary edema.	[102]
6	Secondary (gestational) HT, n = 880	Serum	Elevated^a CT-I levels were a strong independent predictor of pregnancy-induced HT or preeclampsia.	[103]

Table 1. Clinical Studies on the Diagnostic Significance of CTs in Case of HT

No.

Number of patients, diagnosis

Biomaterials

Prevalence and degree of CTs increase in case of HT, predictive significance

References

^aIncreased/elevated level of CTs is a level exceeding the standard 99 percentile provided by the manufacturer of the immunotest. BP: blood pressure; CTs: cardiospecific troponins; CT-T: cardiospecific troponin T; CT-I: cardiospecific troponin I; HT: hypertension.

Primary HT, n = 306

Serum

Increased^a CT-T levels were observed in 47% of patients with high BP and were associated with left ventricular hypertrophy and poor long-term prognosis.

[52]

Primary HT, n = 20

Urine

CT-I levels in the urine of patients with high BP (HT) were significantly higher than in patients with normal BP. Reference intervals for CTs levels in the urine have not yet been established.

[54]

Primary HT, n = 467

Serum

Increased^a CT-I levels were observed in 15% of patients with high BP and were associated with the risk of chronic congestive cardiac failure.

[100]

Primary HT, n = 171

Serum

Increased^a CT-I levels were observed in 32% of patients with high BP and were associated with the increased risk of major adverse cardiac events (MACE) and the risk of coronary heart disease.

[101]

Primary HT, n = 929

Serum

Increased^a CT-I levels were observed in 31% of patients with high BP and were associated with the risk of myocardial infarction and pulmonary edema.

[102]

Secondary (gestational) HT, n = 880

Serum

Elevated^a CT-I levels were a strong independent predictor of pregnancy-induced HT or preeclampsia.

[103]