Author: Garcia-Palmieri, Mario R.

Source: Current Cardiology Reviews, Volume 1, Number 3, November 2005 , pp. 213-223(11)

Publisher: Bentham Science Publishers

Abstract:

With advancing age the large arteries of the body become more stiff and less compliant, which causes an increase in systolic blood pressure and pulse pressure as well as a decrease in diastolic blood pressure.

A perusal of the literature reveals that in the last few years there is ample evidence and multiple publications claiming that a wide pulse pressure, reflecting large artery stiffness, is a significant and at times independent risk factor for cardiovascular disease particularly in the elderly.

This article presents a review and a summary of the salient studies and trials conducted in different institutions and countries correlating the increase in pulse pressure with cardiovascular outcomes primarily cardiovascular mortality, coronary artery disease, myocardial infarction, congestive heart failure and stroke.

The information available, although mainly consistent, is insufficient to determine if the encountered relationship of wide pulse pressure and cardiovascular events is causal or whether wide pulse pressure is just a marker of an underlying disease. There has been no trial to test the benefit of treating wide pulse pressure. In order to decide if pulse pressure will become clinically useful for the definition and management of hypertension and for cardiovascular risk stratification we will need more research and randomized clinical trials to explore if reversal in coronary risk and cardiovascular complications is obtained with drugs that decrease pulse pressure and if pulse pressure monitoring will be useful for coronary risk stratification.

Keywords: wide pulse pressure; arterial stiffness; cardiovascular mortality; heart failure; myocardial infarction; stroke

Document Type: Review article

DOI: http://dx.doi.org/10.2174/157340305774574170

Affiliations: 1: Section of Cardiology, School of Medicine, University of Puerto Rico, P.O. Box 365067, San Juan, Puerto Rico 00936-5067.

Publication date: 2005-11-01

More about this publication?

• Current Cardiology Reviews publishes frontier reviews on all the latest advances on the practical and clinical approach to the diagnosis and treatment of cardiovascular disease. All relevant areas are covered by the journal including arrhythmia, congestive heart failure, cardiomyopathy, congenital heart disease, drugs, methodology, pacing, and preventive cardiology. The journal's aim is to publish the highest quality review articles dedicated to clinical research in the field. The journal is essential reading for all researchers and clinicians in cardiology.

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