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Is high pulse pressure a marker of preclinical cardiovascular disease?

Giovanni de Simone1, Mary J Roman, Michael H Alderman

  • 1Department of Clinical and Experimental Medicine, Federico II University Hospital, via S. Pansini 5, 80131 Naples, Italy. simogi@unina.it

Hypertension (Dallas, Tex. : 1979)
|March 16, 2005
PubMed

Insights

High brachial pulse pressure may indicate preclinical cardiovascular disease in hypertensive individuals, not just a risk factor. This finding suggests pulse pressure is a disease marker, similar to left ventricular mass.

Area of Science:

  • Cardiology
  • Hypertension Research
  • Vascular Medicine

Background:

  • High brachial pulse pressure is traditionally viewed as a cardiovascular risk factor.
  • Its role as a direct indicator of preclinical cardiovascular disease requires further investigation.

Purpose of the Study:

  • To test the hypothesis that high brachial pulse pressure signifies preclinical cardiovascular disease.
  • To differentiate the role of pulse pressure as a marker versus a risk factor in hypertension.

Main Methods:

  • Studied 1250 subjects (normotensive and untreated hypertensive).
  • Estimated central pulse pressure (PP) and divided by stroke volume (SV) to calculate PP/SV.
  • Defined high brachial pulse pressure (>63 mm Hg) and high peripheral resistance (>90th percentile).

Main Results:

  • High brachial pulse pressure was associated with increased left ventricular (LV) mass and higher PP/SV.
  • High peripheral resistance was linked to lower LV dimensions and mass, but higher PP/SV.
  • Associations of high brachial pulse pressure with higher PP/SV and LV mass were independent of other pressure components.

Conclusions:

  • In hypertension, pulse pressure may serve as a marker of preclinical cardiovascular disease.
  • Pulse pressure's role is comparable to left ventricular mass and PP/SV as a disease indicator.
  • Reclassifies pulse pressure from a risk factor to a preclinical disease marker.

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