Related Experiment Videos
Pulse pressure and coronary mortality in elderly men and women from general population
E Casiglia1, V Tikhonoff, A Mazza
1Department of Clinical and Experimental Medicine, University of Padova, Via Giustiniani, 2-35128 Padova, Italy. edoardo.casiglia@unipd.it
Insights
Pulse pressure (PP) better predicts coronary heart disease mortality in elderly women than systolic or diastolic blood pressure alone. This finding highlights PP as a crucial indicator for cardiovascular risk in older female populations.
Area of Science:
- Cardiology
- Gerontology
- Epidemiology
Background:
- Cardiovascular diseases remain a leading cause of mortality in the elderly.
- Traditional blood pressure measurements (systolic and diastolic) have limitations in predicting coronary events.
- Pulse pressure (PP), the difference between systolic and diastolic pressure, warrants further investigation as a predictor.
Purpose of the Study:
- To determine if pulse pressure (PP) is a superior predictor of coronary mortality in the elderly compared to isolated systolic or diastolic blood pressure.
- To analyze the association between PP and coronary mortality in a population-based cohort of elderly individuals.
Main Methods:
- A population-based study of 3282 elderly subjects (age ≥65 years) with repeated blood pressure measurements.
- Data collection included medical history, anthropometrics, blood tests, and 14-year coronary mortality.
- Statistical analyses employed analysis of covariance, Cox analysis, and bivariate vectorial analysis.
Main Results:
- Pulse pressure (PP) significantly predicted coronary mortality in women (1.01 excess risk/mm Hg PP), with higher risk in the highest PP tertile (relative risk 2.90).
- Neither systolic nor diastolic blood pressure alone predicted mortality in women; however, in a Cox model, systolic pressure positively and diastolic pressure negatively affected survival.
- No significant association between systolic blood pressure or PP and mortality was found in men.
Conclusions:
- Pulse pressure (PP) is an independent predictor of coronary mortality in elderly women, outperforming systolic or diastolic pressure alone.
- The combination of systolic and diastolic pressures, reflected in PP, provides critical prognostic information for cardiovascular risk in older females.
- Further research may refine risk stratification strategies for elderly women based on PP measurements.
Abstract:
The aim of this work was to evaluate whether pulse pressure (PP) in elderly people is a better predictor of coronary mortality than systolic and diastolic blood pressure taken alone. For this aim, 3282 elderly subjects aged >or=65 years were studied in a population-based frame. Blood pressure was repeatedly measured and averaged; historical data, anthropometrics, blood tests and 14-year coronary mortality were recorded. Statistics included analysis of covariance, Cox analysis and bivariate vectorial analysis. Coronary mortality in women was predicted by PP (1.01 excess risk/mm Hg PP) and was significantly higher in the 3rd than in the 1st tertile of PP (relative risk 2.90); neither systolic nor diastolic pressure taken alone influenced mortality. When systolic and diastolic pressures were both entered into a Cox model, the former had a positive and the latter a negative effect on survival, confirming a prognostic role of PP. For any given level of systolic pressure, mortality was inversely associated with diastolic pressure. Finally, the mean vector representing both systolic and diastolic pressures of non-surviving women was characterised by higher systolic and lower diastolic components than in non-surviving. No significant trend of mortality in relation to either systolic blood pressure or PP was observed in men. In conclusion, the combination of systolic and diastolic pressure called PP is an independent predictor of coronary mortality in elderly females, and a better predictor than systolic or diastolic pressure alone.