163 Prediction of outcomes in patients with hypertension using clinical laboratory biomarkers - a real-world analysis using a global federated database

<h3>Background</h3> Hypertension is a recognised risk factor for heart failure. The use of biomarkers in heart failure is long established, however little is known about the prognostic significance of these in hypertension when heart failure has been excluded. <h3>Aim</h3> This study aimed to investigate the prognostic significance of routine cardiac biomarkers in hypertensive patients when heart failure has been excluded. <h3>Methods</h3> A retrospective cohort study was performed using electronic medical records from a global federated research network. The database was searched on 20th February 2024. Cardiac biomarkers were the first reported result within 1 month of diagnosis of hypertension, excluding patients with heart failure. Cohorts were grouped according to biomarker-specific thresholds. Cohorts were 1:1 propensity-score matched for demography (age, gender, &amp; ethnicity), baseline comorbidities (hypertension, diabetes mellitus, ischaemic heart disease, AF &amp; smoking status), laboratory data (eGFR &amp; proteinuria ) and medication use. Logistical regression produced odds ratios with 95% CI for incident 5-year major adverse cardiac events (MACE). MACE was defined, a priori, as a composite of acute myocardial infarction, heart failure, atrial fibrillation, stroke, acute heart failure and all-cause mortality. All statistical analyses were performed on the networks online platform. <h3>Results</h3> The results for NTproBNP and Troponin T are shown in tables 1 and 2 respectively. Only results that reached statistical significance (P&lt;0.05) are presented. <h3>Conclusion</h3> Elevated NTproBNP and cardiac troponin T in hypertensive patients who do not have heart failure demonstrate a significant risk of MACE and its individual components. Further prospective validation is warranted to evaluate the prognostic significance of these markers in hypertension, especially those where HF has been excluded. The combination of clinical and laboratory variables into a single risk prediction model should be developed and validated. <h3>Conflict of Interest</h3> N/A