What is "Pulse Pressure" and Why is it Important?
Although most people are not even aware of what it actually is, "pulse pressure" is a better predictor of cardiovascular disease than is mean arterial pressure, according to a new report. Another study found that the two measures are equally predictive of cerebrovascular complications in patients with high blood pressure.
The measurement of pulse pressure is the difference of the two blood pressure measurements -- the systolic (the higher number) and diastolic (the lower number).
The systolic pressure is the highest arterial blood pressure of a cardiac cycle, which occurs immediately after the contraction of the left ventricle of the heart. The diastolic pressure is the lowest arterial blood pressure of a cardiac cycle occurring during the expansion or dilation of the cavities of the heart during which they fill with blood.
Researchers collected data on nearly 8000 older patients with high blood pressure in three separate trials.
They then calculated the relative risks associated with pulse pressure and mean arterial pressure.
"A 10 mm Hg wider pulse pressure increased the risk of major cardiovascular complications ... the increase in risk ranged from approximately 13% for all coronary endpoints to nearly 20% for cardiovascular mortality," the researchers note the study's abstract.
Additionally, the researchers found that the risk of major cardiovascular complications increased with a higher systolic blood pressure. "At any given level of systolic blood pressure, it also rose with lower diastolic blood pressure, suggesting that indeed the wider pulse pressure was driving the risk of major cardiovascular complications."
"Pulse pressure should be considered in future guidelines for assessing and treating hypertensive patients," stated one the researchers in comments to Reuters Health.
A second study group collected data on 2149 subjects with high blood pressure. During the 12-year follow-up, there were 121 cardiac events and 96 cerebrovascular events.
Analysis of the data revealed that both pulse pressure and mean arterial pressure were predictive of cerebrovascular events.
Meeting of the International Society of Hypertension August, 2000
Also, with people on being treated with drugs for high blood pressure, it would be wise for physicians to monitor pulse pressure to make sure that it does not increase, even if the systolic and diastolic levels are reduced. For example, if someone with a BP of 170/100 reduces it down to 160/85, this would mean that the pulse pressure actually went up.
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