title: Ambulatory pulse pressure predicts cardiovascular events in patients with peripheral arterial disease.
abstract: BACKGROUND
  Patients with peripheral arterial disease (PAD) are at high risk of cardiovascular (CV) events and often have hypertension with a high pulse pressure (PP). We studied the prognostic value of ambulatory blood pressure (ABP) in PAD patients with special reference to PP.
  
  
  METHODS
  98 consecutive males with PAD had 24-h ABP measurements. The mean age was 68 years and CV comorbidity was prevalent. The outcome variable was CV events defined as CV mortality or any hospitalization for myocardial infarction, stroke or coronary revascularization. The predictive value of ABP variables was assessed by Cox regression. 90 age-matched men free of CV disease served as controls.
  
  
  RESULTS
  During follow-up (median 71 months), 36 patients and seven controls had at least one CV event. In PAD patients, 24-h PP (hazard ratios, HR, 1.48 (95% confidence interval, CI, 1.14-1.92), p <0.01) predicted CV events. Office PP did not predict events in PAD patients (HR 1.15 (0.97-1.38), ns). In multivariate analysis, 24-h PP (HR 1.48 (1.12-1.95), p <0.01) remained a predictor of CV events.
  
  
  CONCLUSIONS
  Ambulatory PP predicts CV events in patients with PAD. ABP measurement may be indicated for better risk stratification in PAD patients.
authors.affiliation: Karolinska University Hospital Solna, Department of Emergency Medicine, Stockholm, Sweden. per.skoglund@karolinska.se
authors.forename: Per H
authors.initials: PH
authors.lastname: Skoglund
authors.forename: Jan
authors.initials: J
authors.lastname: Östergren
authors.forename: Per
authors.initials: P
authors.lastname: Svensson
mesh_terms: D000368:Aged; D001794:Blood Pressure; D018660:Blood Pressure Monitoring, Ambulatory; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D016022:Case-Control Studies; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D006973:Hypertension / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D058729:Peripheral Arterial Disease / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011379:Prognosis; D013548:Sweden