• Long B, Long DA, Tannenbaum L, Koyfman A. An emergency medicine approach to troponin elevation due to causes other than occlusion myocardial infarction. Am J Emerg Med. 2020;38(5):998–1006. Authors wrote a narrative review of causes of elevated troponin other than myocardial infarction. The review discusses the typical mechanism of troponin elevation and reviews alternative theories on troponin elevation in non myocardial infarction. The authors did thorough review of 208 articles but did not specifically address arterial hypertension.

Article  Google Scholar 

• Tehrani DM, Fan W, Nambi V, Gardin J, Hirsch CH, Amsterdam E, et al. Trends in blood pressure and high-sensitivity cardiac troponin-T with cardiovascular disease: the cardiovascular health study. Am J Hypertens. 2019;32(10):1013–20. Researchers used data from the Cardiovascular Health Study, a longitudinal cohort of older adults, 2,219 subjects showing that an increase in hs-cTnT over time is associated with a higher risk of CVD whether or not blood pressure decreases overtime.

Article  Google Scholar 

Wolf SJ, Lo B, Shih RD, Smith MD, Fesmire FM. American College of Emergency Physicians Clinical Policies C. Clinical policy: critical issues in the evaluation and management of adult patients in the emergency department with asymptomatic elevated blood pressure. Ann Emerg Med. 2013;62(1):59–68.

• Garg P, Morris P, Fazlanie AL, Vijayan S, Dancso B, Dastidar AG, et al. Cardiac biomarkers of acute coronary syndrome: from history to high-sensitivity cardiac troponin. Intern Emerg Med. 2017;12(2):147–55. Review summarizing the history of cardiac biomarkers to provide insights into the use of hs-cTn as a quantitative biomarker marker of cardiomyocyte injury as well as the recent evidence and guidelines for hs-cTn in suspected ACS.

Article  Google Scholar 

• Park KC, Gaze DC, Collinson PO, Marber MS. Cardiac troponins: from myocardial infarction to chronic disease. Cardiovasc Res. 2017;113(14):1708–18. The authors review 103 papers covering basic troponin biology, review of the classic physiology of its detection in the diagnosis of AMI and then review evidence for the elevation of cTn in the absence of cardiomyoctye necrosis. The authors also review the evidence that chronic elevations in cTn are directly correlated to prognosis.

CAS  Article  Google Scholar 

Pons-Llado G, Ballester M, Borras X, Carreras F, Carrio I, Lopez-Contreras J, et al. Myocardial cell damage in human hypertension. J Am Coll Cardiol. 2000;36(7):2198–203.

CAS  Article  Google Scholar 

Fortuno MA, Gonzalez A, Ravassa S, Lopez B, Diez J. Clinical implications of apoptosis in hypertensive heart disease. Am J Physiol Heart Circ Physiol. 2003;284(5):H1495–506.

CAS  Article  Google Scholar 

• Acosta G, Amro A, Aguilar R, Abusnina W, Bhardwaj N, Koromia GA, et al. Clinical determinants of myocardial injury, detectable and serial troponin levels among patients with hypertensive crisis. Cureus. 2020;12(1):e6787. Retrospective study of patients with hypertensive crisis who presented to the emergency department revealing that one-third of patients were found to have detectible troponin.

PubMed  PubMed Central  Google Scholar 

Cuspidi C, Sala C, Tadic M, Gherbesi E, Facchetti R, Grassi G, et al. High-normal blood pressure and abnormal left ventricular geometric patterns: a meta-analysis. J Hypertens. 2019;37(7):1312–9.

CAS  Article  Google Scholar 

• Jespersen MM, Munk Jensen SS, Harbak J, Jeppesen KF, Revsholm J, Nybo M. Can high-sensitivity troponins predict future hypertension? A systematic literature review. Scand J Clin Lab Invest. 2019;79(8):613–8. Literature review of 11 papers associating hs-cTn concentrations and future hypertension, all 11 studies show a strong association but heterogenous studies suggest need for future research to futher define the predictive abilities of hs-cTn.

CAS  Article  Google Scholar 

McEvoy JW, Chen Y, Nambi V, Ballantyne CM, Sharrett AR, Appel LJ, et al. High-sensitivity cardiac troponin T and risk of hypertension. Circulation. 2015;132(9):825–33.

CAS  Article  Google Scholar 

Sato Y, Yamamoto E, Sawa T, Toda K, Hara T, Iwasaki T, et al. High-sensitivity cardiac troponin T in essential hypertension. J Cardiol. 2011;58(3):226–31.

Article  Google Scholar 

• Madan N, Lee AK, Matsushita K, Hoogeveen RC, Ballantyne CM, Selvin E, et al. Relation of isolated systolic hypertension and pulse pressure to high-sensitivity cardiac troponin-T and N-terminal pro-B-type natriuretic peptide in older adults (from the atherosclerosis risk in communities study). Am J Cardiol. 2019;124(2):245–52. The authors performed a cross-sectional analysis of 5,251 study participants in the Atherosclerosis Risk in Communities (ARIC) finding an association between isolated systolic hypertension and hs-cTnT and NT-proBNP in addition they found significantly associated between increasing elevated pulse pressure and elevated hs-cTnT.

CAS  Article  Google Scholar 

• Lindner G, Pfortmueller CA, Braun CT, Exadaktylos AK. Non-acute myocardial infarction-related causes of elevated high-sensitive troponin T in the emergency room: a cross-sectional analysis. Intern Emerg Med. 2014;9(3):335–9. These investigators reivewed 1,573 Emergency Room patients who had elecated serial measurements of high-sensitity troponins and reviewed the causes of the elevated troponins. 1,398 were determined to not have acute coronary syndrome and were included, of note for our review 22 patients were ultimately diagnosed with a hypertensive crisis, in addition in 30% of patients an elevated troponin was not found. While there are limitations to the study, it is very helpful to have this insight specially into the Emergency Department patient with an elevated troponin as much of the primary research addresses long term effects of hypertension and high sensitivity troponins.

Article  Google Scholar 

Korff S, Katus HA, Giannitsis E. Differential diagnosis of elevated troponins. Heart. 2006;92(7):987–93.

CAS  Article  Google Scholar 

Ravichandran J, Woon SY, Quek YS, Lim YC, Noor EM, Suresh K, et al. High-sensitivity cardiac troponin I levels in normal and hypertensive pregnancy. Am J Med. 2019;132(3):362–6.

CAS  Article  Google Scholar 

• Pattanshetty DJ, Bhat PK, Aneja A, Pillai DP. Elevated troponin predicts long-term adverse cardiovascular outcomes in hypertensive crisis: a retrospective study. J Hypertens. 2012;30(12):2410–5. These authors restrospectively reviewed 236 charts of patients who presented with hypertensive crisis and compared those with elevated troponin to those without elevated troponin. The group with elevated troponins had a significantly higher rate of major adverse cardiac events at 2 years in addition to an increased likelihood of underlying obstructive CAD. Despite not using high-sensitivity troponin, this paper is helpful for providing additional evidence both for relationship between hypertensive crisis and acutely elevated troponin and the relationship between elevated troponin and poor patient outcomes.

CAS  Article  Google Scholar 

Pokharel Y, Sun W, de Lemos JA, Taffet GE, Virani SS, Ndumele CE, et al. High-sensitivity troponin T and cardiovascular events in systolic blood pressure categories: atherosclerosis risk in communities study. Hypertension. 2015;65(1):78–84.

CAS  Article  Google Scholar 

Askin L, Yesiltepe Y. High-sensitivity cardiac troponin T levels in prehypertensive patients. Clin Exp Hypertens. 2018;40(4):332–6.

CAS  Article  Google Scholar 

Takahashi Y, Satoh M, Ohmomo H, Tanaka F, Osaki T, Tanno K, et al. Association between high-sensitivity cardiac troponin T and future cardiovascular incidence in a general Japanese population: results from the Tohoku medical megabank project. Biomarkers. 2019;24(6):566–73.

CAS  Article  Google Scholar