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Pulse pressure and risk for myocardial infarction and heart failure in the elderly

V Vaccarino1, T R Holford, H M Krumholz

  • 1Department of Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut 06520-8034, USA. viola.vaccarino@yale.edu

Journal of the American College of Cardiology
|July 18, 2000
PubMed

Insights

Elevated pulse pressure (PP) independently predicts coronary heart disease (CHD), congestive heart failure (CHF), and mortality in older adults. This finding highlights PP as a crucial cardiovascular risk factor in the elderly population.

Area of Science:

  • Cardiology
  • Gerontology
  • Public Health

Background:

  • Current hypertension guidelines overlook combined systolic and diastolic blood pressure effects.
  • Pulse pressure (PP) shows promise as a cardiovascular endpoint predictor, but data in community-dwelling elderly are limited.

Purpose of the Study:

  • To determine if pulse pressure (PP) is an independent predictor of coronary heart disease (CHD), congestive heart failure (CHF), and overall mortality in community-dwelling elderly individuals.

Main Methods:

  • A cohort of 2,152 elderly individuals (age ≥65) without baseline CHD or CHF was studied.
  • Blood pressure, including PP, was measured at baseline, and outcomes (CHD, CHF, mortality) were monitored over 10 years.

Main Results:

  • A 10-mm Hg increase in PP correlated with a 12% rise in CHD risk, 14% in CHF risk, and 6% in mortality.
  • PP demonstrated a stronger association with cardiovascular endpoints than systolic blood pressure (SBP), diastolic blood pressure (DBP), or mean arterial pressure (MAP).
  • The predictive value of PP remained significant even after adjusting for demographics, comorbidities, risk factors, and medication use.

Conclusions:

  • Elevated pulse pressure is a potent, independent predictor of cardiovascular events and mortality in the elderly.
  • PP provides critical prognostic information beyond traditional blood pressure measures for cardiovascular risk assessment in older adults.
Abstract

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