Importance of arterial pulse pressure as a predictor of coronary heart disease risk in PROCAM.
OBJECTIVE
To investigate pulse pressure (PP) as an independent predictor of coronary heart disease (CHD) risk.


RESULTS
On the basis of a 10-year follow-up of 5389 men aged 35-65 at recruitment into PROCAM, we used a proportional hazards model to calculate the effect of systolic blood pressure (SBP), diastolic blood pressure (DBP), and PP on CHD risk after correcting for age, high-density lipoprotein cholesterol, LDL cholesterol, triglycerides, smoking, diabetes, and family history of premature CHD. Increases of 10 mmHg in DBP, SBP, and PP were associated with an increased CHD hazard ratio (HR) of approximately 10%. When the group was divided into the age groups <50, 50-59, and >59 years, this relationship was seen in the age group 50-59 years for DBP, SBP, and PP and in men aged > or =60 for PP only (25% increase in HR). Overall, CHD risk in men with PP > or =70 mmHg was more three times that of men with PP <50 mmHg. This increased risk was not apparent at age <50 years, was greatest at age >60 years, and was also present in men who were normotensive at recruitment (SBP < or =160 mmHg, DBP < or =95 mmHg).


CONCLUSIONS
In older European men, increased PP is an important independent determinant of coronary risk, even among those initially considered normotensive.
Assmann
Gerd
G
Institute of Arteriosclerosis Research at the University of Münster, Münster, Germany. assmann@uni-muenster.de
Cullen
Paul
P
Evers
Thomas
T
Petzinna
Dieter
D
Schulte
Helmut
H
D000328:Adult; D000368:Aged; D000959:Antihypertensive Agents / Q000627:therapeutic use; D001794:Blood Pressure / Q000502:physiology*; D001795:Blood Pressure Determination / Q000592:standards; D003327:Coronary Disease / Q000175:diagnosis* / Q000401:mortality / Q000503:physiopathology; D004812:Epidemiologic Methods; D006333:Heart Failure / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality / Q000503:physiopathology; D011674:Pulse
D000959:Antihypertensive Agents