[Role of pulse pressure, systolic blood pressure, and diastolic blood pressure in the prediction of cardiovascular risk. Cohort study]. / Papel de la presión de pulso, presión arterial sistólica y presión arterial diastólica en la predicción del riesgo cardiovascular. Estudio de cohortes.

BACKGROUND AND OBJECTIVE: To analize the role of pulse pressure (PP), systolic (SBP) and diastolic blood pressure (DBP), in the prediction of cardiovascular risk. PATIENTS AND METHOD: A prospective cohort study carried out in 2 primary care center, including 932 patients aged between 35-84 years old, without cardiovascular events, selected by simple random sampling, and with an 8 year follow-up. PP, SBP, and DBP were categorized in tertiles, comparing the upper with the 2 lowers. First cardiovascular event, whether fatal or not, such as coronary heart disease, cerebrovascular disease, and peripheral arterial disease was recorded as a composite variable. Results were studied according to Cox models, adjusting for age, sex, smoking, total cholesterol, high density lipoprotein cholesterol, and diabetes mellitus. We studied the correlation between PP with SBP, DBP, and cardiovascular risk factors. RESULTS: We registered 85 cardiovascular events: 43 cases of coronary heart disease, 27 cerebrovascular disease, and 17 peripheral arterial disease. The adjusted hazard ratios for composite variable were: upper PP tertile (>/= 59 mmHg) = 1.3 (95% confidence interval [CI], 0.8-2.1); upper SBP tertile (>/= 140 mmHg) = 1.5 (95% CI, 1.0-2.5); upper DBP tertile (>/= 84 mmHg) = 1.1 (95% CI, 0.7-1.8). Results were similar for specific cardiovascular events. PP was correlated with SBP (r = 0.825; p < 0.001), age (r = 0.422; p < 0.001), diabetes mellitus (r = 0.242; p < 0.001), and smoking (r = -0.158; p = 0.01), with adjusted hazard ratio for these variables of 1.0 (95% CI, 0.6-1.9). CONCLUSIONS: PP is an arterial pressure component very correlated with SBP and other factors, but is not a better cardiovascular risk predictor than SBP.

Papel de la presión de pulso, presión arterial sistólica y presión arterial diastólica en la predicción del riesgo cardiovascular. Estudio de cohortes / Role of pulse pressure, systolic blood pressure, and diastolic blood pressure in the prediction of cardiovascular risk. Cohort study

FUNDAMENTO Y OBJETIVO: Analizar el papel de la presión de pulso (PP), la presión arterial sistólica(PAS) y la diastólica (PAD) en la predicción del riesgo cardiovascular.PACIENTES Y MÉTODO: Se realizó un estudio de cohortes, prospectivo, en 2 centros de salud, queincluyó a 932 personas de 35-84 años sin episodios cardiovasculares, seleccionadas por muestreoaleatorio simple y seguidas durante 8 años. La PP, PAS y PAD se categorizaron en tercilesy el superior se comparó con los 2 inferiores. Se registró como variable combinada el primerepisodio cardiovascular, mortal o no, en forma de cardiopatía isquémica, enfermedad cerebrovasculary arteriopatía periférica. Los resultados se analizaron mediante modelos de Cox ajustandopor edad, sexo, tabaquismo, colesterol total, colesterol unido a lipoproteínas de alta densidady diabetes mellitus. Se estudió la correlación entre PP y PAS, PAD y factores de riesgocardiovascular.RESULTADOS: Se registraron 85 episodios cardiovasculares: 43 casos de cardiopatía isquémica,27 de enfermedad cerebrovascular y 17 de arteriopatía periférica. Los cocientes de riesgo ajustadospara la variable combinada fueron: tercil superior (>= 59 mmHg) de la PP = 1,3 (intervalode confianza [IC] del 95%, 0,8-2,1); tercil superior (>= 140 mmHg) de la PAS = 1,5 (IC del95%, 1,0-2,5); tercil superior (>= 84 mmHg) de la PAD = 1,1 (IC del 95%, 0,7-1,8). Los resultadosfueron similares para los episodios cardiovasculares específicos. La PP se correlacionócon la PAS (r = 0,825; p < 0,001), la edad (r = 0,422; p < 0,001), la diabetes mellitus(r = 0,242; p < 0,001) y el tabaquismo (r = –0,158; p = 0,01), siendo su cociente de riesgoajustado por estas variables de 1,0 (IC del 95%, 0,6-1,9).CONCLUSIONES: La PP es un componente de la presión arterial muy relacionado con la PAS yotros factores de riesgo, pero no es mejor predictor del riesgo cardiovascular que la PAS

BACKGROUND AND OBJECTIVE: To analize the role of pulse pressure (PP), systolic (SBP) and diastolicblood pressure (DBP), in the prediction of cardiovascular risk.PATIENS AND METHOD: A prospective cohort study carried out in 2 primary care center, including932 patients aged between 35-84 years old, without cardiovascular events, selected by simplerandom sampling, and with an 8 year follow-up. PP, SBP, and DBP were categorized in tertiles,comparing the upper with the 2 lowers. First cardiovascular event, whether fatal or not, such ascoronary heart disease, cerebrovascular disease, and peripheral arterial disease was recorded asa composite variable. Results were studied according to Cox models, adjusting for age, sex,smoking, total cholesterol, high density lipoprotein cholesterol, and diabetes mellitus. We studiedthe correlation between PP with SBP, DBP, and cardiovascular risk factors.RESULTS: We registered 85 cardiovascular events: 43 cases of coronary heart disease, 27 cerebrovasculardisease, and 17 peripheral arterial disease. The adjusted hazard ratios for compositevariable were: upper PP tertile (>= 59 mmHg) = 1.3 (95% confidence interval [CI], 0.8-2.1);upper SBP tertile (>= 140 mmHg) = 1.5 (95% CI, 1.0-2.5); upper DBP tertile (>= 84 mmHg) =1.1 (95% CI, 0.7-1.8). Results were similar for specific cardiovascular events. PP was correlatedwith SBP (r = 0.825; p < 0.001), age (r = 0.422; p < 0.001), diabetes mellitus (r =0.242; p < 0.001), and smoking (r = –0.158; p = 0.01), with adjusted hazard ratio for thesevariables of 1.0 (95% CI, 0.6-1.9).CONCLUSIONS: PP is an arterial pressure component very correlated with SBP and other factors,but is not a better cardiovascular risk predictor than SBP