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Pulse pressure and cardiovascular risk.

A Benetos1

  • 1Centre IPC and INSERM U 337, Paris, France.

Journal of Hypertension. Supplement : Official Journal of the International Society of Hypertension
|March 8, 2000
PubMed
Summary

Diastolic blood pressure (DBP) is an unreliable cardiovascular risk predictor. Widened pulse pressure (PP), the difference between systolic and diastolic blood pressure, is a superior indicator of cardiac events and mortality risk.

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Area of Science:

  • Cardiology
  • Hypertension Research
  • Vascular Medicine

Background:

  • Elevated diastolic blood pressure (DBP) and systolic blood pressure (SBP) correlate with cardiac events.
  • DBP was historically favored for cardiovascular risk assessment due to smaller variations.
  • Recent findings challenge DBP's reliability, indicating SBP increases with age while DBP plateaus.

Purpose of the Study:

  • To evaluate the predictive value of diastolic blood pressure (DBP) for cardiovascular events.
  • To investigate the role of pulse pressure (PP) as a predictor of cardiovascular risk.
  • To determine if PP is a more reliable indicator of cardiac events than traditional blood pressure measures.

Main Methods:

  • Analysis of existing studies and data on blood pressure readings and cardiac events.
  • Comparison of the predictive accuracy of DBP, SBP, and PP for cardiovascular outcomes.
  • Examination of the impact of arterial stiffening and peripheral vascular resistance on blood pressure readings.

Main Results:

  • DBP can be misleading, masking underlying cardiovascular risks due to counteracting physiological factors.
  • Systolic blood pressure (SBP) is a more consistent indicator of age-related cardiovascular risk.
  • Widened pulse pressure (PP) is strongly associated with increased risk of mortality and myocardial infarction, even in normotensive individuals.

Conclusions:

  • Diastolic blood pressure (DBP) is no longer a reliable predictor of cardiovascular events.
  • Pulse pressure (PP) emerges as a superior and independent predictor of cardiovascular risk.
  • Measuring PP offers a more accurate assessment of cardiac event risk, particularly in older adults and those with isolated systolic hypertension.

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