Background: Pulse pressure (PP) is associated with increased afterload and myocardial oxygen demand. PP is also associated with poor prognosis in patients with myocardial infarction and heart failure with preserved ejection fraction. Silent myocardial damage is associated with cardiovascular mortality in the general population. The aim of this study was to investigate the relationship between PP and silent myocardial damage in the general population. Methods and Results: The present study included 3505 subjects who participated in health checkup. We measured serum heart-type fatty acid binding protein (H-FABP) and brain natriuretic peptide (BNP) levels as markers of silent myocardial damage. Subjects were divided into four groups according to the quartiles of PP. Subjects with the highest PP group showed higher serum H-FABP and BNP levels. Multivariate logistic analysis showed that the higher PP was independently associated with silent myocardial damage evaluated by H-FABP (odds ratio (OR): 1.12, P < .05) and BNP (OR: 1.10, P < .05). Receiver operating characteristic (ROC) analysis showed that PP performed best in predicting silent myocardial damage evaluated by H-FABP and BNP compared with systolic blood pressure (BP), diastolic BP, and mean BP (c-index regarding H-FABP: 0.61, P < .05; c-index regarding BNP: 0.61, P < .05). Conclusions: High PP was related to higher H-FABP and BNP levels, suggesting that asymptomatic subjects with high PP may be exposed to myocardial damage.
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