[Pulse pressure and mean pressure: physiopathology and predictive value of coronary events and ictus]

Abstract

Increased pulse pressure (PP) reflects an increased stiffness of aorta and other large elastic arteries. These arteries dilate by about 10% during systole and contract owing to elastic return during diastole. As a result, blood flow towards periphery becomes less pulsatile and more continuous. An increased stiffness of aorta and large elastic arteries due to progressively reduced elastic content with aging (atherosclerotic processes) leads to increased systolic blood pressure (BP), because of their reduced distension during systole, and decreased diastolic BP due to their reduced blood content at the beginning of diastole. Several epidemiological studies have shown that PP is the BP component which most closely predicts cardiovascular risk, particularly over 55 years of age. In particular, increased PP is an important predictor of coronary events, while increased mean BP is a more specific predictor of cerebrovascular events.