Pulse pressure amplification and risk of cardiovascular disease.
BACKGROUND
Whether pulse pressure amplification (PPA) relates to established markers of cardiovascular risk is unknown. The purpose of this study was to investigate the relationship between PPA and cardiovascular risk factors and cardiovascular risk in a population-based sample of 40- to 80-year old men.


METHODS
A cross-sectional, single-center study was performed in 400 men aged 40-80 years. PPA was calculated as a ratio (brachial pulse pressure/central pulse pressure). Detailed information on vascular risk factors was obtained. Aortic pulse wave velocity (PWV) and common carotid intima-media thickness (CIMT), as markers of vascular risk, were measured. We calculated the absolute 10-year risk of coronary heart disease using the Framingham risk score. Regression analysis was used to evaluate the relations under study.


RESULTS
In models adjusted for age, mean arterial pressure (MAP), heart rate, and height, significant inverse relations with PPA were found for waist-to-hip ratio, triglycerides, smoking, pack-years, and hypertension. Furthermore, an increased PPA was significantly inversely related to aortic PWV, common CIMT, and history of symptomatic vascular disease. Finally, the Framingham risk score decreased with increasing PPA.


CONCLUSIONS
Our study shows that a higher PPA reflects a lower vascular risk in men between 40 and 80 years of age, as shown by a better cardiovascular risk profile, a reduced PWV, common CIMT, and a lower Framingham risk of coronary heart disease.
Nijdam
Marie-Elise
ME
Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
Plantinga
Yvonne
Y
Hulsen
Hans T
HT
Bos
Willem J W
WJ
Grobbee
Diederick E
DE
van der Schouw
Yvonne T
YT
Bots
Michiel L
ML
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology* / Q000503:physiopathology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging / Q000503:physiopathology; D002784:Cholesterol / Q000097:blood; D003430:Cross-Sectional Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D011379:Prognosis; D011674:Pulse; D012307:Risk Factors; D014280:Triglycerides / Q000097:blood; D014463:Ultrasonography
D014280:Triglycerides; D002784:Cholesterol