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Abstract：
BACKGROUND: Subclinical myocardial injury expressed as higher cardiac troponin concentrations may represent an important intermediary between hypertension and the risk of cardiovascular disease. The study aimed to assess the relative strength of associations between systolic blood pressure (BP), diastolic BP, and pulse pressure, and subclinical myocardial injury, and how change in BP variables over time associates with subclinical myocardial injury.
RESULTS: cTnl (cardiac troponin I) was measured in 32 968 participants of the fourth wave of the population-based cohort HUNT4 (Trøndelag Health Study) without a history of cardiovascular disease. An additional longitudinal analysis included participants from HUNT4 with BP measurements from HUNT3 (n=18 681). Associations between BP variables and cTnI concentrations were assessed by linear and logistic regression analyses. The median cTnI concentration was 1.6 ng/L (25th-75th percentiles, 0.6-3.1 ng/L), median age was 52 years (39.1-65.6 years), and 57% were female subjects. Cross-sectionally, only systolic BP categories ≥130 mm Hg associated with higher cTnI concentrations, compared with a reference systolic BP of <110 mm Hg. All categories of diastolic BP and pulse pressure were positively associated with higher cTnI concentrations when diastolic BP 70 to 79 mm Hg and pulse pressure <40 mm Hg were used as references, respectively. When comparing systolic BP, diastolic BP, and pulse pressure as continuous variables, cross-sectionally, pulse pressure most strongly associated with cTnI concentrations (P for all comparisons <0.001), whereas longitudinally, change in diastolic BP was most strongly associated with cTnI concentrations (P for all comparisons <0.05).
CONCLUSIONS: Subjects with high pulse pressure and longitudinal increase in diastolic BP are at higher risk for subclinical myocardial injury.
RESULTS: cTnl (cardiac troponin I) was measured in 32 968 participants of the fourth wave of the population-based cohort HUNT4 (Trøndelag Health Study) without a history of cardiovascular disease. An additional longitudinal analysis included participants from HUNT4 with BP measurements from HUNT3 (n=18 681). Associations between BP variables and cTnI concentrations were assessed by linear and logistic regression analyses. The median cTnI concentration was 1.6 ng/L (25th-75th percentiles, 0.6-3.1 ng/L), median age was 52 years (39.1-65.6 years), and 57% were female subjects. Cross-sectionally, only systolic BP categories ≥130 mm Hg associated with higher cTnI concentrations, compared with a reference systolic BP of <110 mm Hg. All categories of diastolic BP and pulse pressure were positively associated with higher cTnI concentrations when diastolic BP 70 to 79 mm Hg and pulse pressure <40 mm Hg were used as references, respectively. When comparing systolic BP, diastolic BP, and pulse pressure as continuous variables, cross-sectionally, pulse pressure most strongly associated with cTnI concentrations (P for all comparisons <0.001), whereas longitudinally, change in diastolic BP was most strongly associated with cTnI concentrations (P for all comparisons <0.05).
CONCLUSIONS: Subjects with high pulse pressure and longitudinal increase in diastolic BP are at higher risk for subclinical myocardial injury.
摘要：
背景：以较高的心肌肌钙蛋白浓度表示的亚临床心肌损伤可能是高血压和心血管疾病风险之间的重要中介。该研究旨在评估收缩压(BP)之间的相关强度，舒张压,和脉压，亚临床心肌损伤，以及血压变量随时间的变化如何与亚临床心肌损伤相关。
结果：cTnl（心肌肌钙蛋白I）是在没有心血管疾病史的基于人群的队列HUNT4（Trøndelag健康研究）的第四波中的32968名参与者中测量的。另一项纵向分析包括来自HUNT4的参与者和来自HUNT3的BP测量(n=18681)。通过线性和逻辑回归分析评估BP变量与cTnI浓度之间的关联。cTnI浓度中位数为1.6ng/L(第25-75百分位数，0.6-3.1ng/L)，中位年龄为52岁（39.1-65.6岁），57%是女性受试者。跨领域,只有收缩压类别≥130mmHg与更高的cTnI浓度相关，与参考收缩压<110mmHg相比。当使用舒张压70至79mmHg和脉压<40mmHg作为参考时，所有类别的舒张压和脉压均与较高的cTnI浓度呈正相关。分别。比较收缩压时,舒张压,和脉压作为连续变量，横截面，脉压与cTnI浓度密切相关(所有比较的P<0.001)，而纵向，舒张压的变化与cTnI浓度密切相关(所有比较P<0.05).
结论：高脉压和舒张压纵向升高的受试者发生亚临床心肌损伤的风险较高。
结果：cTnl（心肌肌钙蛋白I）是在没有心血管疾病史的基于人群的队列HUNT4（Trøndelag健康研究）的第四波中的32968名参与者中测量的。另一项纵向分析包括来自HUNT4的参与者和来自HUNT3的BP测量(n=18681)。通过线性和逻辑回归分析评估BP变量与cTnI浓度之间的关联。cTnI浓度中位数为1.6ng/L(第25-75百分位数，0.6-3.1ng/L)，中位年龄为52岁（39.1-65.6岁），57%是女性受试者。跨领域,只有收缩压类别≥130mmHg与更高的cTnI浓度相关，与参考收缩压<110mmHg相比。当使用舒张压70至79mmHg和脉压<40mmHg作为参考时，所有类别的舒张压和脉压均与较高的cTnI浓度呈正相关。分别。比较收缩压时,舒张压,和脉压作为连续变量，横截面，脉压与cTnI浓度密切相关(所有比较的P<0.001)，而纵向，舒张压的变化与cTnI浓度密切相关(所有比较P<0.05).
结论：高脉压和舒张压纵向升高的受试者发生亚临床心肌损伤的风险较高。
