[Relationship between pulse pressure and clinical cardiovascular damage in elderly subjects of EPICARDIAN study].
BACKGROUND
Arterial hypertension and aging are the main cardiovascular risk factors (CVRF) in the elderly population. Aging is associated with an increase in systolic blood pressure (SBP) levels and a decrease of diastolic blood pressure (DBP), due to increased large artery stiffness. Several epidemiological studies have demonstrated that pulse pressure (PP) is an independent risk factor, better than SBP, for overall, cardiovascular mortality, coronary heart disease and cerebrovascular, particularly in the elderly.


OBJECTIVE
To determine the association of PP with clinical cardiovascular damage, in a population-based sample of Spanish elders subjects. To quantify the association between PP and the background of clinical cardiovascular damage. To determine which PP, SBP, DBP or mean arterial pressure (MAP) are better associated to the history of clinical cardiovascular damage.


METHODS
The sample analyzed included individuals from the EPICARDIAN study in the areas of Lista district (Madrid) and Arévalo (Avila). The following CVRF of age, gender, hypertension, diabetes, dyslipidemia, obesity, abdominal obesity and smoking were considered. Clinical cardiovascular damage is defined as the personal background of stroke, myocardial infarction, angina pectoris and/or intermittent claudication.


RESULTS
The sample included 2665 individuals, 56% women, mean age: 74 year-old; 74.3% were hypertensive, 55.6% had central obesity and 31.9% hypercholesterolemia. In the multivariate analysis, the PP was the BP parameter associated most to stroke, angina pectoris and intermittent claudication: OR, 1.015, (95% CI: 1.001-1.030), 1.029 (95% CI: 1.006-1.052) and 1.012 (95% CI: 1.002-1.023), respectively.


CONCLUSIONS
In the elderly population studied, an elevated PP is the component of arterial pressure with the greatest association to the background of cardiovascular damage.
Fernández-Escribano Hernández
M
M
Unidad de Hipertensión, Hospital Universitario de la Princesa, Madrid, España. merche_feh@hotmail.com
Suárez Fernández
C
C
Sáez Vaquero
T
T
Blanco
F
F
Alonso Arroyo
M
M
Rodríguez Salvanés
F
F
Gabriel Sánchez
R
R
Vega Quiroga
S
S
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001794:Blood Pressure; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000453:epidemiology*; D008297:Male; D012307:Risk Factors