(Hypertension. 1997;30:1410-1415.)
© 1997 American Heart Association, Inc.
Articles |
Pulse Pressure
A Predictor of Long-term Cardiovascular Mortality in a French Male Population
From the Investigations Préventives et Cliniques (A.B., A.R., L.G.), Paris, France; Institut National de la Santé et de la Recherche Médicale (INSERM) U337 (A.B., M.S.) and U258 (J.-L.R., P.D., L.G.), Paris, France; and Department of Medicine (H.S.), State University of New York, Syracuse, NY.
Correspondence to Athanase Benetos, MD, PhD, Investigations Préventives et Cliniques (IPC), 23 rue de Lubeck, 75116 Paris, France.
Abstract Studies on the usefulness of blood pressure as a
prognostic factor in cardiovascular disease have more
often involved investigations of the levels of diastolic or
systolic blood pressure. However, blood pressure may be divided
into two other components: steady (mean pressure) and pulsatile (pulse
pressure). In this study, the relationship of pulse pressure to
cardiovascular mortality was investigated in 19 083
men 40 to 69 years old who were undergoing a routine systematic health
examination and were being followed up after a mean period of 19.5
years. Subjects were divided into four groups according to age (40 to
54 and 55 to 69 years) and mean arterial pressure (<107
and 
107 mm Hg). Each group was further divided into four
subgroups according to the pulse pressure level. A wide pulse pressure
(evaluated according to the quartile group or as a continuous
quantitative variable) was an independent and significant predictor
of all-cause, total cardiovascular, and, especially,
coronary mortality in all age and mean pressure groups. No
significant association between pulse pressure and cerebrvascular
mortality was observed. In conclusion, in a large population of men
with a relatively low cardiovascular risk, a wide pulse
pressure is a significant independent predictor of all-cause,
cardiovascular, and, especially, coronary
mortality.
Key Words: mortality • blood pressure • pulse pressure • cardiovascular disease
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