מתוך medicontext.co.il
WESTPORT, CT (Reuters Health) – Pulse pressure is a useful indicator of heart failure and stroke risk among elderly patients being treated for isolated systolic hypertension, according to a report in the November 1st issue of The American Journal of Cardiology.
"Little is known regarding pulse pressure as a predictor of cardiovascular outcomes in elderly persons with isolated systolic hypertension, and the influence of treatment on the pulse pressure effect," Dr. Viola Vaccarino, of Emory University School of Medicine in Atlanta, and colleagues note.
The researchers examined the association between pulse pressure, measured over 5 years, and the incidence of coronary heart disease, heart failure, and stroke in 4632 members of the Systolic Hypertension in the Elderly Program, a randomized, placebo-controlled study of isolated systolic hypertension treatment in older adults.
"In the treatment group, a 10-mm Hg increase in pulse pressure was associated with a statistically significant 32% increase in risk of heart failure and a 24% increase in risk of stroke after controlling for systolic blood pressure and other know risk factors," the investigators write.
After controlling for diastolic blood pressure and other risk factors, a 10-mm Hg increase in pulse pressure was associated with a 23% increased risk of heart failure and a 19% increased risk of stroke among the treated patients.
In the placebo group, pulse pressure was not a significant predictor of heart failure or stroke, according to the authors. They add that pulse pressure was not significantly associated with the incidence of coronary heart disease in either the placebo or the treatment group.
"In these patients, monitoring of pulse pressure during antihypertensive treatment should be a useful tool for risk stratification, and should help optimize treatment regimens," Dr. Vaccarino's group concludes. "Decreasing pulse pressure in addition to systolic blood pressure may offer additional benefits to these patients."
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