Increase in pulse pressure relates to diabetes mellitus and low HDL cholesterol, but not to hyperlipidemia in hypertensive patients aged 50 years or older.
Higher pulse pressure is associated with higher cardiovascular risk. We investigated the relationship between pulse pressure and known metabolic risk factors in hypertensive patients who had not experienced stroke or myocardial infarction. In a multicenter cross-sectional survey made in 1995, we registered 939 hypertensive patients aged > or = 50 years. Of these, 734 had never experienced stroke or myocardial infarction. We divided these 734 patients into two groups based on the value of their pulse pressures: 396 patients with a pulse pressure > or = 60 mmHg, and 338 patients with a pulse pressure<60 mmHg. The average pulse pressure value was 72 +/- 12 mmHg in the former group, and 49 +/- 8 mmHg in the latter group. The former group exhibited advanced age, a higher women-to-men ratio, lower high-density lipoprotein (HDL) cholesterol, and higher systolic and lower diastolic blood pressure. Diabetes mellitus (DM) and left ventricular hypertrophy were more frequently noticed in the former group than in the latter group. The prevalence of hyperlipidemia, however, was similar in the two groups. The association of pulse pressure with DM and low HDL cholesterol was statistically significant by multiple logistic analysis adjusted for age, sex, and other known cardiovascular risk factors. In conclusion, pulse pressure increases with advancing age. DM made a substantially larger contribution to the increase in pulse pressure than hyperlipidemia.
Third Department of Internal Medicine, University of the Ryukyus School of Medicine, Okinawa, Japan. sannai@med.u-ryukyu.ac.jp
Takako
T
Miyagi
Hiromi
H
Muratani
Yorio
Y
Kimura
Koshiro
K
Fukiyama
Yuhei
Y
Kawano
Jun
J
Fujii
Keishi
K
Abe
Iwao
I
Kuwajima
Masao
M
Ishii
Toshiaki
T
Shiomi
Hiroshi
H
Mikami
Setsuro
S
Ibayashi
Teruo
T
Omae
D000319:Adrenergic beta-Antagonists / Q000494:pharmacology; D000368:Aged; D001794:Blood Pressure / Q000502:physiology*; D008076:Cholesterol, HDL / Q000097:blood*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006949:Hyperlipidemias / Q000503:physiopathology*; D006973:Hypertension / Q000097:blood / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking
D000319:Adrenergic beta-Antagonists; D008076:Cholesterol, HDL