{
  "abstract": "Background Most patients with hypertension exhibit detectable and elevated concentrations of natriuretic peptides (BNP/NTproBNP), and troponin when assessed using high-sensitivity assays. However, the prognostic relevance of this finding has not been clearly established so far in hypertensive patients without heart failure. In this systematic review, we aimed to evaluate the prognostic utility of BNP or NT-proBNP and troponin T/I for risk stratification in hypertensive patients, excluding those with heart failure.Methods This systematic review was registered in PROSPERO (CRD42024552031). A systematic literature search was conducted by two researchers independently using 2 online databases Ovid Medline and Web of Science to identify studies from 2013 to 2025. Data retrieved from articles were used in line with the PRISMA statement guidelines. The primary end point were major adverse cardiac events (MACE) – defined as a composite outcome of myocardial infarction, heart failure, atrial fibrillation, HF hospitalisation, stroke and all-cause mortality. Secondary outcomes were individual components of MACE outcome. Descriptive analysis was performed, and data presented in tabular form.Results Nineteen studies were retrieved with 7,519 participants distributed across various study designs ( figure 1): 10 prospective cohort studies, 6 randomized controlled trials, 2 retrospective studies and 1 cross-sectional study. Majority of studies predicted all-cause mortality and heart failure outcomes. Findings (figure 2) demonstrated the clinical significance of BNP/NT-proBNP and troponin T and I in cardiac risk assessment, however, heterogeneity in biomarker focus and methodologies may limit comparability.Conclusion The obtained results suggest that elevated cardiac biomarkers BNP/NT-proBNP and troponins are associated with significantly higher risk of MACE and are powerful predictors of end organ damage. However, large-scale studies are required to validate the robustness and prognostic utility of these biomarkers within current risk stratification of patients with hypertension.Abstract 5-021 Figure 1Flow chart of included studies in the reviewAbstract 5-021 Figure 2Forest plot showing hazard ratios and 95% confidence interval",
  "authors": [
    {
      "affiliations": [
        "Liverpool Centre for Cardiovascular Science at Liverpool John Moores University (LJMU), University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK",
        "School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK"
      ],
      "name": "Elliot Mbeta"
    },
    {
      "affiliations": [
        "Liverpool Centre for Cardiovascular Science at Liverpool John Moores University (LJMU), University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK",
        "School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK"
      ],
      "name": "Katie Williams"
    },
    {
      "affiliations": [
        "Liverpool Centre for Cardiovascular Science at Liverpool John Moores University (LJMU), University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK",
        "School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK"
      ],
      "name": "James Yates"
    },
    {
      "affiliations": [
        "Liverpool Centre for Cardiovascular Science at Liverpool John Moores University (LJMU), University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK",
        "Department of Cardiology, Liverpool University Hospitals NHS Foundation Trust, Liverpool, UK"
      ],
      "name": "Rajiv Sankaranarayanan"
    },
    {
      "affiliations": [
        "Liverpool Centre for Cardiovascular Science at Liverpool John Moores University (LJMU), University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK",
        "School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK"
      ],
      "name": "Peter Penson"
    },
    {
      "affiliations": [
        "Liverpool Centre for Cardiovascular Science at Liverpool John Moores University (LJMU), University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK",
        "Danish Centre for Health Services Research, Department of Clinical Medicine, Aalborg University, Aalborg, Denmark",
        "Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK"
      ],
      "name": "Gregory YH Lip"
    },
    {
      "affiliations": [
        "Liverpool Centre for Cardiovascular Science at Liverpool John Moores University (LJMU), University of Liverpool and Liverpool Heart and Chest Hospital, Liverpool, UK",
        "School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, UK",
        "Cardiovascular and Metabolic Medicine, Institute of Life Course and Medical Sciences, University of Liverpool, Liverpool, UK",
        "Research Laboratory, Liverpool Heart and Chest Hospital Liverpool, England, UK"
      ],
      "name": "Garry McDowell"
    }
  ],
  "title": "5-021 Evaluating the prognostic significance of circulating biomarkers of end organ damage in hypertension: a systematic literature review",
  "uid": "428ba1b0-9db4-511c-8eaf-81999b232691"
}