[Arterial pulse pressure].
A WELL IDENTIFIED RISK FACTOR: Other than systolic, diastolic and mean pressure, arterial pulse pressure (or differential pressure) is an independent factor of cardiovascular and notably coronary risk. The role of this factor is now clearly quantified in untreated hypertensive patients, but also in treated apparently controlled patients, and in patients with normal blood pressure. Demonstration of the deleterious role of an increase in pulse pressure was also made in populations at high risk of events such as heart failure, post-infarction or in hemodialyzed patients. FROM A THERAPEUTIC POINT OF VIEW: Antihypertensive treatments have inconstant efficacy on pulse pressure and new therapeutic routes appear promising. However, in the absence of available proof that a strategy axed on the decrease in pulse pressure improves cardiovascular prognosis, current recommendations do not yet include pulse pressure levels in therapeutic strategies. AN EFFICIENT MARKER: Whilst awaiting further data, the measurement of pulse pressure, because of its pertinence and simplicity, provides the practitioner with one of the most efficient markers for screening persons at high risk of cardiovascular and particularly coronary risk.
Mourad
Jean-Jacques
JJ
Service de médecine interne et HTA, Hôpital Saint-Michel, 33, rue Olivier de Serres 75730 Paris. jean-jacques.mourad@hopital-saint-michel.org
D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000187:drug effects / Q000502:physiology; D003327:Coronary Disease / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D006333:Heart Failure / Q000209:etiology* / Q000503:physiopathology / Q000517:prevention & control; D006439:Hemodynamics / Q000187:drug effects / Q000502:physiology; D006801:Humans; D006973:Hypertension / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D011379:Prognosis; D006435:Renal Dialysis; D012307:Risk Factors
D000959:Antihypertensive Agents