(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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I. B. Wilkinson, K. Prasad, I. R. Hall, A. Thomas, H. MacCallum, D. J. Webb, M. P. Frenneaux, and J. R. Cockcroft Increased central pulse pressure and augmentation index in subjects with hypercholesterolemia J. Am. Coll. Cardiol., March 20, 2002; 39(6): 1005 - 1011. [Abstract] [Full Text] [PDF]
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P. C. Deedwania The Changing Face of Hypertension: Is Systolic Blood Pressure the Final Answer? Arch Intern Med, March 11, 2002; 162(5): 506 - 508. [Full Text] [PDF]
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A. Benetos, F. Thomas, K. Bean, S. Gautier, H. Smulyan, and L. Guize Prognostic Value of Systolic and Diastolic Blood Pressure in Treated Hypertensive Men Arch Intern Med, March 11, 2002; 162(5): 577 - 581. [Abstract] [Full Text] [PDF]
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G. Bobrie and J. F Potter The elderly hypertensive population: what lies ahead of us? Journal of Renin-Angiotensin-Aldosterone System, March 1, 2002; 3(1_suppl): S4 - S9. [PDF]
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J. Blacher and M. Safar Specific aspects of high blood pressure in the elderly Journal of Renin-Angiotensin-Aldosterone System, March 1, 2002; 3(1_suppl): S10 - S15. [PDF]
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 I.S. Mackenzie, I.B. Wilkinson, and J.R. Cockcroft Assessment of arterial stiffness in clinical practice QJM, February 1, 2002; 95(2): 67 - 74. [Full Text] [PDF]
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J. L. Abramson, W. S. Weintraub, and V. Vaccarino Association Between Pulse Pressure and C-Reactive Protein Among Apparently Healthy US Adults Hypertension, February 1, 2002; 39(2): 197 - 202. [Abstract] [Full Text] [PDF]
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 E. Nicolaides and C. J. Jones Review: Type 2 diabetes -- implications for macrovascular mechanics and disease The British Journal of Diabetes & Vascular Disease, January 1, 2002; 2(1): 9 - 12. [Abstract] [PDF]
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P. Boutouyrie, A. I. Tropeano, R. Asmar, I. Gautier, A. Benetos, P. Lacolley, and S. Laurent Aortic Stiffness Is an Independent Predictor of Primary Coronary Events in Hypertensive Patients: A Longitudinal Study Hypertension, January 1, 2002; 39(1): 10 - 15. [Abstract] [Full Text] [PDF]
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 M. ZUREIK, A. BENETOS, C. NEUKIRCH, D. COURBON, K. BEAN, F. THOMAS, and P. DUCIMETIERE Reduced Pulmonary Function Is Associated with Central Arterial Stiffness in Men Am. J. Respir. Crit. Care Med., December 15, 2001; 164(12): 2181 - 2185. [Abstract] [Full Text] [PDF]
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G. M. London, B. Pannier, A. P. Guerin, J. Blacher, S. J. Marchais, B. Darne, F. Metivier, H. Adda, and M. E. Safar Alterations of Left Ventricular Hypertrophy in and Survival of Patients Receiving Hemodialysis: Follow-up of an Interventional Study J. Am. Soc. Nephrol., December 1, 2001; 12(12): 2759 - 2767. [Abstract] [Full Text] [PDF]
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C. Vlachopoulos, K. Hirata, and M. F. O'Rourke Pressure-Altering Agents Affect Central Aortic Pressures More Than Is Apparent From Upper Limb Measurements in Hypertensive Patients: The Role of Arterial Wave Reflections Hypertension, December 1, 2001; 38(6): 1456 - 1460. [Abstract] [Full Text] [PDF]
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I. B. Wilkinson, S. S. Franklin, I. R. Hall, S. Tyrrell, and J. R. Cockcroft Pressure Amplification Explains Why Pulse Pressure Is Unrelated to Risk in Young Subjects Hypertension, December 1, 2001; 38(6): 1461 - 1466. [Abstract] [Full Text] [PDF]
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J. L. Izzo Jr, T. S. Manning, and B. E. Shykoff Office Blood Pressures, Arterial Compliance Characteristics, and Estimated Cardiac Load Hypertension, December 1, 2001; 38(6): 1467 - 1470. [Abstract] [Full Text] [PDF]
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 J. Westerbacka, A. Seppala-Lindroos, and H. Yki-Jarvinen Resistance to Acute Insulin Induced Decreases in Large Artery Stiffness Accompanies the Insulin Resistance Syndrome J. Clin. Endocrinol. Metab., November 1, 2001; 86(11): 5262 - 5268. [Abstract] [Full Text] [PDF]
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T. SHOJI, M. EMOTO, K. SHINOHARA, R. KAKIYA, Y. TSUJIMOTO, H. KISHIMOTO, E. ISHIMURA, T. TABATA, and Y. NISHIZAWA Diabetes Mellitus, Aortic Stiffness, and Cardiovascular Mortality in End-Stage Renal Disease J. Am. Soc. Nephrol., October 1, 2001; 12(10): 2117 - 2124. [Abstract] [Full Text] [PDF]
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M. Domanski, J. Norman, M. Wolz, G. Mitchell, and M. Pfeffer Cardiovascular Risk Assessment Using Pulse Pressure in the First National Health and Nutrition Examination Survey (NHANES I) Hypertension, October 1, 2001; 38(4): 793 - 797. [Abstract] [Full Text] [PDF]
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L. M.A.B. Van Bortel, H. A.J. Struijker-Boudier, and M. E. Safar Pulse Pressure, Arterial Stiffness, and Drug Treatment of Hypertension Hypertension, October 1, 2001; 38(4): 914 - 921. [Abstract] [Full Text] [PDF]
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T. K. Waddell, A. M. Dart, T. L. Medley, J. D. Cameron, and B. A. Kingwell Carotid Pressure Is a Better Predictor of Coronary Artery Disease Severity Than Brachial Pressure Hypertension, October 1, 2001; 38(4): 927 - 931. [Abstract] [Full Text] [PDF]
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W. C. Cushman, B. J. Materson, D. W. Williams, and D. J. Reda Pulse Pressure Changes With Six Classes of Antihypertensive Agents in a Randomized, Controlled Trial Hypertension, October 1, 2001; 38(4): 953 - 957. [Abstract] [Full Text] [PDF]
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G. M. London, J. Blacher, B. Pannier, A. P. Guerin, S. J. Marchais, and M. E. Safar Arterial Wave Reflections and Survival in End-Stage Renal Failure Hypertension, September 1, 2001; 38(3): 434 - 438. [Abstract] [Full Text] [PDF]
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C. Labat, P. Lacolley, M. Lajemi, M. de Gasparo, M. E. Safar, and A. Benetos Effects of Valsartan on Mechanical Properties of the Carotid Artery in Spontaneously Hypertensive Rats Under High-Salt Diet Hypertension, September 1, 2001; 38(3): 439 - 443. [Abstract] [Full Text] [PDF]
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K. Miura, A. R. Dyer, P. Greenland, M. L. Daviglus, M. Hill, K. Liu, D. B. Garside, and J. Stamler Pulse Pressure Compared With Other Blood Pressure Indexes in the Prediction of 25-Year Cardiovascular and All-Cause Mortality Rates: The Chicago Heart Association Detection Project in Industry Study Hypertension, August 1, 2001; 38(2): 232 - 237. [Abstract] [Full Text] [PDF]
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R. H. Fagard, K. Pardaens, J. A. Staessen, and L. Thijs The pulse pressure-to-stroke index ratio predicts cardiovascular events and death in uncomplicated hypertension J. Am. Coll. Cardiol., July 1, 2001; 38(1): 227 - 231. [Abstract] [Full Text] [PDF]
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E.-R. Rietzschel, E. Boeykens, M. L. De Buyzere, D. A. Duprez, and D. L. Clement A Comparison Between Systolic and Diastolic Pulse Contour Analysis in the Evaluation of Arterial Stiffness Hypertension, June 1, 2001; 37 (6): e15 - e22. [Abstract] [Full Text] [PDF]
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P. Verdecchia, G. Schillaci, G. Reboldi, S. S. Franklin, and C. Porcellati Different Prognostic Impact of 24-Hour Mean Blood Pressure and Pulse Pressure on Stroke and Coronary Artery Disease in Essential Hypertension Circulation, May 29, 2001; 103(21): 2579 - 2584. [Abstract] [Full Text] [PDF]
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S. Laurent, P. Boutouyrie, R. Asmar, I. Gautier, B. Laloux, L. Guize, P. Ducimetiere, and A. Benetos Aortic Stiffness Is an Independent Predictor of All-Cause and Cardiovascular Mortality in Hypertensive Patients Hypertension, May 1, 2001; 37(5): 1236 - 1241. [Abstract] [Full Text] [PDF]
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