Systolic and Diastolic Blood Pressure, Cardiac Biomarkers, and Cardiovascular Mortality in Adults Without Cardiovascular Disease

Figures

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  Figure 1. Age-Standardized Prevalence of Elevated High-Sensitivity Cardiac Troponin T and N-Terminal Pro-Brain Natriuretic Peptide by Systolic and Diastolic Blood Pressure Categories (A) Age-standardized prevalence of elevated high-sensitivity cardiac troponin T by systolic blood pressure categories. (B) Age-standardized prevalence of N-terminal pro-brain natriuretic peptide by systolic blood pressure categories. (C) Age-standardized prevalence of high-sensitivity cardiac troponin T by diastolic blood pressure categories. (D) Age-standardized prevalence of elevated N-terminal pro-brain natriuretic peptide by diastolic blood pressure categories. Ref, the reference category for SBP (120-129) and DBP (70-79) represents the lowest prevalence of elevated hs-cTnT or NT-proBNP. ∗Estimate differs significantly (P < 0.05) from the reference category highlighted in deep gray. hs-cTnT = high-sensitivity cardiac troponin T; NT-proBNP = N-terminal pro-brain natriuretic peptide.

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  Figure 2. The Association Between Blood Pressure Combination and Elevated Levels of Serum High-Sensitivity Cardiac Troponin T or N-Terminal Pro-Brain Natriuretic Peptide (A) The association between blood pressure combination and elevated levels of serum high-sensitivity cardiac troponin T. (B) The association between blood pressure combination and elevated levels of N-terminal pro-brain natriuretic peptide. Nor, normal. PRRs (95% CIs) were adjusted for age, sex, race/ethnicity, body mass index, smoking status, heavy drink, physical activity, diabetes, use of hypertension medication, estimated glomerular filtration rate, total cholesterol/high-density lipoprotein, triglycerides. DBP = diastolic blood pressure; PRR = prevalence rate ratio; SBP = systolic blood pressure; other abbreviations as in Figure 1.

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  Figure 3. Adjusted Incidence Rate Ratio for All-Cause and Cardiovascular Mortality and the Combinations of Blood Pressure and High-Sensitivity Cardiac Troponin T Levels (A) Adjusted incidence rate ratio for all-cause mortality and the combinations of systolic blood pressure and high-sensitivity cardiac troponin T levels. (B) Adjusted incidence rate ratio for cardiovascular mortality and the combinations of systolic blood pressure and high-sensitivity cardiac troponin T levels. (C) Adjusted incidence rate ratio for all-cause mortality and the combinations of diastolic blood pressure and high-sensitivity cardiac troponin T levels. (D) Adjusted incidence rate ratio for cardiovascular mortality and the combinations of diastolic blood pressure and high-sensitivity cardiac troponin T levels. Ref, treating the SBPnorTNTlow or DBPnorTNTlow group as reference. SBPlow: <110 mm Hg; SBPnormal: 110 to 129 mm Hg; SBPhigh: ≥130 mm Hg. DBPlow: <70 mm Hg; DBPnor: 70 to 79 mm Hg; DBPhigh: ≥80 mm Hg. TNTlow: <14 ng/L; TNThigh: ≥14 ng/L. IRR (95% CIs) were adjusted as in Figure 2. IRR = incide nce rate ratio; other abbreviations as in Figures 1 and 2.

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  Central Illustration. The Associations Between Blood Pressure, Cardiac Biomarkers, and Cardiovascular Mortality Risk The high collinearity between DBP and SBP as well as their distinctive associations with subclinical myocardium injury or stress highlight the importance of distinct blood pressure and biomarker components. CVD = cardiovascular disease; hs-cTnI = high-sensitivity cardiac troponin I; other abbreviations as in Figures 1, 2, and 3.