[Value of pulse pressure as a cardiovascular risk marker]

Pulse pressure is calculated as the difference between the systolic and diastolic components of arterial blood pressure. Epidemiological studies have demonstrated that pulse pressure elevation directly correlates with cardiovascular mortality and morbidity, as well as with target organ damage. From a pathophysiological point of view, pulse pressure can be considered a marker of the rigidity of large arteries, especially aorta. Loss of elastic properties of these large arteries is crucial in the development of isolated systolic hypertension, prevalent in the majority of the elderly, and in difficulties in organ perfusion. Some recent data suggest that both sedentary life and obesity enhance this loss of arterial elasticity. Pulse pressure reduction by antihypertensive treatment in subjects with elevation of this parameter (isolated systolic hypertensives) protects against cardiovascular disease. Nevertheless, the independence of this protection regarding other blood pressure components or the existence of clear differences between antihypertensive drug classes on pulse pressure reduction are still unknown.