不同血压变量之间的关联强度以及亚临床心肌损伤。首先，SBP、DBP和PP均与cTnI浓度相关，与已确定的心血管风险因素无关。其次，从横截面上看，PP是与较高cTnI浓度（亚临床心肌损伤的一种表达）最密切相关的血压变量，这与先前的研究结果一致，即PP比SBP和DBP更能预测HF^[18-19]。第三，当对血压变量进行分类评估时，与参考类别相比，60~69 mmHg的DBP在与cTnI浓度相关方面表现出最低的非标准化β系数，而只有高血压类别的SBP和所有类别的PP以剂量依赖的方式与较高cT nI浓度相关。第四，SBP、DBP和PP与cTnI表现出不同程度的非线性关联。最后，DBP的变化似乎是与较高的cTnI浓度纵向相关最强烈的血压变量。这些发现证实并扩展了先前关于血压与心肌肌钙蛋白T （cTnT）表达的亚临床心肌损伤之间关系的数据，并可能对血压监测、血压靶点的个性化和治疗强度具有潜在意义。

当评估不同类别的血压变量如何与亚临床心肌损伤相关时，只有当高血压类别与SBP＜110mmHg进行比较时，SBP才与cTnI浓度相关。这与先前的研究一致，即SBP越高，cTnT浓度越高^[4-5]。考虑到临床意义，研究发现SBP越高越与cTnI浓度相关，这支持了越来越多的证据，即心肌肌钙蛋白浓度代表收缩性高血压和CVD事件风险增加之间的相互关系，并可用于对高血压患者进行CVD风险进行分层^[1,4]。与DBP在70~79 mmHg相比，DBP在60~69 mm Hg与cTn I浓度相关的B系数最低，而DBP< 60 mmHg和DBP >80 mmHg显示cTnI浓度更高。这一观察结果与DBP以剂量依赖性和分级方式与亚临床心肌损伤相关的概念相一致，DBP水平低至80~89 mmHg^[6]，也与先前发现的“J曲线”相一致，其中低和高DBP类别与冠心病风险增加相关^[6,16-17]。这些观察结果表明，低至70~79 mmHg（甚至60~69 mmHg）的DBP可能是最佳的，应作为参考。

PP在所有类别中都与cTnI浓度显著相关，这为PP和cTnI浓度之间比SBP和DBP和cTn浓度之间更强的横截面关联提供了理由。PP类别和cTnI浓度之间的剂量依赖性关联的观察结果与动脉硬度增加（以PP增加表示）导致心肌损伤的理论一致，反映在较高的cTnI浓度中。在评估非线性关联时，所有3个血压变量都显示出与cTnI的非线性关联。对于较低的血压水平，SBP、DBP和cTnI的曲线图看起来是平坦的，然后在某些血压阈值后给人一种正的螺旋上升的趋势。然而，关于PP和cTnI浓度的图似乎描绘了在所有PP水平上cTnI的线性趋势。

在特定时间，PP是与亚临床心肌损伤相关最强的血压变量。当考虑到血压随时间的变化如何影响cTnI浓度时，DBP的变化是血压变量中最强的标志。高PP和DBP纵向增加的受试者发生亚临床心肌损伤的风险更高。

-END-

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