Pulse pressure predicts mortality in elderly patients.
BACKGROUND
Pulse pressure (PP) values increase with age. The impact of PP on mortality in elderly patients has not been established.


OBJECTIVE
To evaluate the effect of PP on mortality among very elderly hospitalized patients.


METHODS
A prospective clinical study.


METHODS
The medical records of 420 inpatients aged >60 (187 males, mean age of 81.4 +/- 7 years) hospitalized in an acute geriatric ward were reviewed. Patients were followed up for a mean of 3.46 +/- 1.87 years. Mortality data were extracted from death certificates. Using relative operating characteristic (ROC) curves, we identified PP of 62.5 mmHg as a cutoff point. Subjects were categorized as having low PP (< or = 62.5 mmHg; N = 116) or high PP (>62.5 mmHg; N = 304).


RESULTS
The mortality rate was greater in patients with high PP than in those with low PP. During the follow-up, 201 patients died, 155 patients (51%) in the high PP group and 46 patients (39.7%) in the low PP group (p = 0.038). Pulse pressure was associated with all-cause mortality (HR = 1.69, 95% CI = 1.19-2.38, p = 0.003) even after controlling for gender, age, diabetes mellitus, atrial fibrillation and heart rate.


CONCLUSIONS
High PP is an independent predictor of mortality among elderly hospitalized patients.
Weiss
Avraham
A
Geriatric Ward, Rabin Medical Center, Petah Tikvah, Israel. avrahamw@clalit.org.il
Boaz
Mona
M
Beloosesky
Yichayaou
Y
Kornowski
Ran
R
Grossman
Ehud
E
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D001794:Blood Pressure / Q000502:physiology*; D002318:Cardiovascular Diseases / Q000401:mortality* / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D006973:Hypertension / Q000401:mortality / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012307:Risk Factors; D015996:Survival Rate / Q000639:trends