Novel Biomarker Identifies HF in Hypertension

Individuals with hypertension who have higher concentrations of fibroblast growth factor-23 (FGF23) are at a significantly higher risk for heart failure (HF), according to a new study—and antihypertensive therapy has no effect on that risk.

To reach this conclusion, the researchers studied data on 2858 participants in the Multi-Ethnic Study of Atherosclerosis (MESA). At baseline, the participants had hypertension but did not have cardiovascular disease.

IF YOU LIKE THIS, READ MORE...

Hypertension Before Age 40 Could Lead to High CVD Risk

Is Treating Mild Hypertension Beneficial?

Over a 14-year median follow-up, the researchers analyzed the association of baseline serum intact FGF23 with the incidence of HF and whether angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker therapy had an effect on risk.

The researchers determined that higher FGF23 was associated with a 63% greater risk for HF; this risk remained even after excluding participants with chronic kidney disease. No difference was seen in risk among participants taking angiotensin-converting enzyme inhibitors or angiotensin II receptor blocker therapy.

Among a random subgroup of the participants, the researchers also evaluated the relationship between FGF23 and aldosterone and plasma renin activity; they found no association.

“Our findings suggest that FGF23 may be an important biomarker for HF risk in adults with hypertension,” the researchers concluded. “Further research is necessary to determine the mechanisms by which FGF23 leads to increased HF risk and whether therapy with RAAS antagonism reduces this risk among adults with hypertension and in general populations.”

—Colleen Murphy

Reference:

Akhabue E, Vu THT, Vaidya A, et al. Fibroblast growth factor-23, heart failure risk, and renin–angiotensin–aldosterone-system blockade in hypertension: the MESA study. Am J Hypertens. 2019;32(1):18-25. https://doi.org/10.1093/ajh/hpy142.