Standardizing the comparison of systolic blood pressure vs. pulse pressure for predicting coronary heart disease

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Published on: May 3, 2018

Karina W Davidson1, Donald C Haas, Daichi Shimbo

  • 1College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA. kd2124@columbia.edu

Journal of Clinical Hypertension (Greenwich, Conn.)
|June 9, 2006
PubMed

Insights

Systolic blood pressure (SBP) is a stronger predictor of coronary heart disease than pulse pressure (PP). This finding is based on a long-term analysis of NHANES I participants, offering crucial insights for cardiovascular risk assessment.

Area of Science:

  • Cardiovascular Medicine
  • Epidemiology
  • Public Health

Background:

  • The relative predictive power of systolic blood pressure (SBP) and pulse pressure (PP) for coronary heart disease (CHD) remains a subject of ongoing scientific debate.
  • Understanding which blood pressure parameter is a superior indicator of cardiovascular risk is crucial for effective prevention strategies.

Purpose of the Study:

  • To compare the predictive value of SBP versus PP for incident coronary heart disease events.
  • To determine whether SBP or PP is a stronger independent predictor of cardiovascular outcomes.

Main Methods:

  • Analysis of 6032 participants from the first National Health and Nutritional Examination Survey (NHANES I).
  • Longitudinal follow-up for an average of 16 years to ascertain coronary heart disease outcomes from hospital and mortality records.
  • Multivariate-adjusted Cox proportional hazard analyses were employed to estimate relative risks (RR).

Main Results:

  • Both SBP and PP were identified as significant predictors of coronary heart disease.
  • When measured as an increase of 10 mm Hg, PP showed a greater relative risk (RR) than SBP.
  • However, when measured as a 1 standard deviation (SD) increase, SBP demonstrated a larger RR compared to PP.

Conclusions:

  • Systolic blood pressure (SBP) exhibits a greater relative risk for coronary heart disease events compared to pulse pressure (PP).
  • While both SBP and PP are valuable predictors, SBP appears to be the more dominant factor in assessing long-term cardiovascular risk.

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