After adjustment for age, sex, race, history of hypertension, diabetes and CVD, baseline LV EF, BMI, systolic blood pressure, serum albumin, hemoglobin, phosphorus, plasma 25(OH) D and 1,25(OH)2D, participants with FGF-23 concentrations in the highest tertile had an 8% decrease in LV EF during follow-up, compared to participants in the lowest tertile (β –8.0, 95% CI –15.5 to –0.53; p = 0.04). The gene discussed is FGF23; the disease is hypertensive disorder.