Related Experiment Video

Updated: Aug 14, 2026

Pulse-Wave Velocity, Flow-Mediated Dilation, and Carotid Intima-Media Thickness to Assess Cardiovascular Risk in Population with Metabolic Syndrome
06:04

Pulse-Wave Velocity, Flow-Mediated Dilation, and Carotid Intima-Media Thickness to Assess Cardiovascular Risk in Population with Metabolic Syndrome

Published on: September 27, 2024

Pulse pressure predicts cardiovascular risk in patients with type 2 diabetes mellitus

John R Cockcroft1, Ian B Wilkinson, Marc Evans

  • 1Department of Cardiology, University of Wales College of Medicine, University Hospital, Cardiff, Wales. cockcroftjr@cf.ac.uk

American Journal of Hypertension
|November 11, 2005
PubMed

Insights

Pulse pressure (PP) better predicts coronary heart disease (CHD) risk than systolic blood pressure (SBP) in type 2 diabetes patients. However, SBP is a stronger predictor for cerebrovascular (CVD) and peripheral vascular disease (PVD) events.

Area of Science:

  • Cardiovascular Medicine
  • Endocrinology
  • Hypertension Research

Background:

  • Arterial stiffness, indicated by pulse pressure (PP), is a known predictor of coronary heart disease (CHD) risk in older adults.
  • Type 2 diabetes patients face elevated cardiovascular disease (CVD) risk, but the predictive value of PP in this population is unclear.

Purpose of the Study:

  • To determine if pulse pressure (PP) is a superior predictor of cardiovascular events compared to systolic blood pressure (SBP) and diastolic blood pressure (DBP) in individuals with type 2 diabetes.
  • To assess the differential predictive value of PP, SBP, and DBP for coronary heart disease (CHD), cerebrovascular disease (CVD), and peripheral vascular disease (PVD) in this cohort.

Main Methods:

  • Analysis of data from 2911 type 2 diabetes subjects from The Cardiff Diabetes Database.
  • Logistic regression models were employed to evaluate the association between blood pressure components and cardiovascular event risk, adjusting for key risk factors.
  • Correction for age, gender, cholesterol levels, and smoking status was performed to isolate the impact of blood pressure metrics.

Main Results:

  • Over a 4-year follow-up, 574 CHD, 168 CVD, and 157 PVD events occurred.
  • Both PP and SBP showed a positive association with the risk of all event types; DBP was not significantly associated.
  • PP was the strongest predictor for CHD events, while SBP was the best predictor for CVD and PVD events.

Conclusions:

  • Pulse pressure (PP) demonstrates superior predictive value for coronary heart disease (CHD) events in individuals with type 2 diabetes compared to systolic blood pressure (SBP).
  • Conversely, systolic blood pressure (SBP) is a better predictor of cerebrovascular (CVD) and peripheral vascular disease (PVD) events in this patient group.
  • These findings highlight the differential prognostic significance of various blood pressure components in type 2 diabetes for distinct cardiovascular outcomes.
Abstract

Related Concept Videos

Blood Pressure01:24

Blood Pressure

The movement of blood in a human body, commonly referred to as blood flow, is determined by the volume of blood that traverses a certain section of the bodily system per unit time. It is the rhythmic contraction of the heart's ventricles that primarily instigates this movement. As the ventricles contract, blood is forced into the prominent arteries, which then flow from areas of greater pressure to lower pressure areas. This movement continues into smaller arteries and arterioles and...
Blood Pressure01:30

Blood Pressure

Blood pressure (BP) is the pressure or force of blood exerted on the artery's walls as it circulates through the body. It is essential for maintaining blood flow throughout the body.
The average BP in an adult is typically around 120/80 mmHg (millimeters of mercury). In this measurement, the numerator (120) indicates the systolic pressure, which is the pressure in the arteries during the contraction of the heart's ventricles as blood is expelled. The denominator (80) represents the diastolic...
Measurement of Blood Pressure01:17

Measurement of Blood Pressure

Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a stethoscope.
Pre-Procedural Guidelines for Assessing Blood Pressure01:10

Pre-Procedural Guidelines for Assessing Blood Pressure

Accurate blood pressure assessment is crucial for diagnosing and managing various health conditions. To ensure the reliability of these measurements, healthcare professionals must adhere to standardized pre-procedural guidelines. These guidelines enhance patient safety and improve the overall quality of healthcare. The following steps are essential for obtaining accurate and consistent blood pressure readings, from using the appropriate tools to ensuring effective communication with the patient.
Hypertension and Regulation of Blood Pressure01:18

Hypertension and Regulation of Blood Pressure

Hypertension, the most common cardiovascular disease, is diagnosed through repeated measurements of elevated blood pressure. Its risks, including damage to the kidney, heart, and brain, are directly proportional to blood pressure levels. Starting from 115/75 mm Hg, the risk of cardiovascular disease doubles with each increment of 20/10 mm Hg. The diagnosis relies on blood pressure measurements, not on patient symptoms, as hypertension is often asymptomatic until end-organ damage is imminent or...
Sites for measuring blood pressure01:21

Sites for measuring blood pressure

Blood pressure measurement is a fundamental clinical procedure, providing crucial data for assessing cardiovascular health. Among the various sites for this measurement, the brachial and popliteal arteries are predominantly utilized due to their accessibility and the reliability of their readings. This lesson delves into the anatomical significance, methodology, and considerations of measuring blood pressure at these locations.
The Brachial Artery: Primary Site for Blood Pressure Measurement