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Increased total mortality as a function of 24-h pulse pressure dipping.
W Sobiczewski1, M Wirtwein2, D Jarosz3
1Department of Cardiology, Medical University of Gdansk, Gdansk, Poland.
Journal of Human Hypertension
|May 1, 2015
Summary
Pulse pressure dipping is linked to cardiovascular events and mortality in elderly patients with coronary artery disease. This finding highlights age-specific risks associated with blood pressure patterns in cardiovascular disease management.
Area of Science:
- Cardiology
- Geriatrics
- Hypertension Research
Background:
- Elevated pulse pressure (PP) is a known cardiovascular disease (CV) risk factor.
- Understanding PP's impact across different age groups in coronary artery disease (CAD) patients is crucial.
Purpose of the Study:
- To investigate the association between PP and major adverse CV events (MACE), and all-cause/CV mortality in CAD patients.
- To analyze these associations across various age demographics.
Main Methods:
- Prospective study (PROGNOSIS) including 891 CAD patients.
- Utilized receiver operating characteristic analysis for PP dipping prediction.
- Employed COX proportional hazards models for risk assessment, adjusting for covariates.
Main Results:
- Follow-up: 8.3 years; 27% all-cause deaths, 13% CV deaths.
- MACE occurred in 50% of subjects; 65% underwent revascularization.
- PP dipping associated with MACE and total mortality significantly only in the oldest CAD patient group.
Conclusions:
- PP dipping is a significant predictor of MACE, CV, and total mortality in very elderly CAD patients.
- Nocturnal PP values tend to exceed diurnal values in this specific demographic.
- Age-specific risk stratification for PP is warranted in CAD management.
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