J Transcat Intervent.2019;27:eA20190011.
Pulse pressure as a risk factor for cardiovascular events: myth or reality?
Márcio Rogério de Souza Braite
, Márcio Antônio dos Santos, Wilson Pedro Guimarães Neto, Júlio Cesar Queiróz de França, Isabela Gomes Carvalho, Moacir Fernandes de Godoy
DOI: 10.31160/JOTCI201927A20190011
ABSTRACT
Background
Elevated systolic blood pressure and decreased diastolic blood pressure increase systolic load, with concurrent decrease in coronary perfusion pressure. Researches suggested a relation between elevated pulse pressure and morbidity and mortality due to cardiovascular events. This study set out to investigate whether pulse pressure is a predisposing risk factor for coronary heart disease or an aggravating risk factor in patients with coronary artery disease.
Methods
A total of 5,027 pressure registers were evaluated. Pulse pressure was determined invasively in the ascending aorta. Coronary artery disease was diagnosed in the presence of obstructive lesion with luminal diameter reduction of 50% or more in at least one major epicardial vessel. Intergroup comparisons were performed using the unpaired Student’s t test or Mann-Whitney test, as indicated. Categorical variables were compared using the Chi-squared test. Long-term survival was assessed using Kaplan-Meier curves. The p values ≤0.05 were considered significant.
Results
Pulse pressure ranged from 20.0 to 160.0mmHg (mean ± standard deviation: 68.4±22.3; median: 66.0mmHg; 75 th percentile: 82.0mmHg). Pulse pressure was associated with risk factors for coronary artery disease when patients with and without obstructive coronary artery disease were compared. However, pulse pressure was not an independent predictor of mortality.
Conclusion
Pulse pressure is not an independent predictor of mortality in patients with coronary artery disease undergoing angiography.
Keywords: Atherosclerosis; Blood pressure; Cardiovascular diseases; Pulse; Risk Factors; Survival
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