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Is Pulse Pressure an Independent Risk Factor for Incident Stroke, REasons for Geographic And Racial Differences in

Stephen P Glasser1, Daniel L Halberg2, Charles D Sands3

  • 1Department of Medicine, Division of Preventive Medicine, University of Alabama at Birmingham, Birmingham, Alabama, USA; sglasser@uabmc.edu.

American Journal of Hypertension
|January 16, 2015
PubMed

Insights

Pulse pressure is linked to stroke risk, but this association disappears when accounting for systolic blood pressure. Systolic blood pressure remains a key predictor of stroke events.

Area of Science:

  • Cardiovascular epidemiology
  • Neurology
  • Hypertension research

Background:

  • Pulse pressure (PP) is increasingly recognized as a potential risk factor for stroke.
  • Understanding the independent contribution of PP versus other blood pressure parameters (SBP, DBP, MAP) to stroke incidence is crucial for risk stratification and management.

Purpose of the Study:

  • To examine the relationship between incident stroke and various blood pressure measurements, including pulse pressure (PP), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP).
  • To determine if PP is an independent predictor of stroke after adjusting for SBP and other established risk factors.

Main Methods:

  • Analysis of data from the REasons for Geographic And Racial Differences in Stroke (REGARDS) national cohort study.
  • Inclusion of 30,239 Black and White participants aged ≥45 years, enrolled between 2003 and 2007.
  • Use of Cox-proportional hazards models to assess the association between BP measurements and incident stroke, with multivariable adjustments for sociodemographic and clinical factors.

Main Results:

  • During a mean follow-up of 6.3 years, 916 strokes occurred among 25,462 participants.
  • Unadjusted analyses showed associations of PP, SBP, MAP, and DBP with stroke risk.
  • After adjusting for SBP and other risk factors, the association between PP and stroke was attenuated (HR=0.98), while SBP remained a significant predictor (HR=1.14).

Conclusions:

  • Pulse pressure is associated with incident stroke, but this association is not independent of systolic blood pressure.
  • Systolic blood pressure remains a significant independent predictor of stroke.
  • No significant gender, racial, or regional differences were observed in the association between PP and stroke.
Abstract

Keywords:
blood pressurehypertensionincident stroke.pulse pressure

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