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. 2002 Oct 15;30(6):374-80.
doi: 10.1016/s0212-6567(02)79050-1.

[Pulse pressure as a marker of cardiovascular risk among the elderly]

[Article in Spanish]
R Villa Estébanez  1 , S Tranche Iparraguirre, R Marín Iranzo, M A Prieto Díaz, E Hevia Rodríguez; Grupo Oviedo de Hipertensión
Affiliations

[Pulse pressure as a marker of cardiovascular risk among the elderly]

[Article in Spanish]
R Villa Estébanez et al. Aten Primaria. .

Abstract
in English, Spanish

Objective: To verify the clinical significance and the prognostic value of taking the pulse in the general elderly population.

Design: Transversal descriptive study between June and October 2000 within primary care.Participants. A simple randomised sample of 415 people was obtained from the population aged 60 or over (n=8,026) from sixteen lists of six health centres in Asturias.

Main measurements: Demographic variables and cardiovascular risk factors were analysed and the presence of associated cardiovascular pathology was investigated. The analysis divided blood pressure at the pulse into terciles.

Results: 338 people (18.5% losses), with an average age of 73+/-7, 64% of whom were women, were included. The SP and DP means were 140+/-18 and 80+/-8 mm Hg, respectively. The pulse pressure terciles were: tercile 1, (3/4)51 mm Hg, tercile 2, 52-65 mm Hg and tercile 3, >=66 mm Hg. Those in tercile 3 were older than those in tercile 1 (P<.001) and had higher SP figures (P<.001). Tercile 3 was linked to greater prevalence of Hypertension, isolated systolic hypertension and worse control of hypertension; and also to greater prevalence of ischaemic cardiopathy (P=.018) and of overall cardiovascular pathology (P=.005). After logistical regression analysis, pulse pressure persisted as an independent variable (P=.017).

Conclusions: Among the elderly as a whole, blood pressure at the pulse is an independent marker of cardiovascular risk.

Objetivo: Verificar el significado clínico y el valor pronóstico de la presión de pulso en población general anciana.

Diseño: Estudio descriptivo transversal realizado entre junio y octubre de 2000, en el ámbito de atención primaria.

Participantes: De la población de edad 3 60 años (n = 8.026) de 16 cupos de seis centros de salud de Asturias se obtuvo una muestra aleatoria simple de 415 personas.

Mediciones principales: Se analizaron variables demográficas y factores de riesgo cardiovascular y se investigó la presencia de patología cardiovascular asociada. El análisis se realizó mediante la división en terciles de la presión de pulso.

Resultados: Se incluyó a 338 personas (18,5% de pérdidas), con una edad media de 73 ± 7 años; el 64% eran mujeres. Las medias de la presión arterial sistólica (PAS) y diastólica (PAD) fueron 140 ± 18 y 80 ± 8 mmHg, respectivamente. Los terciles de presión de pulso fueron: tercil 1, £ 51 mmHg; tercil 2, 52–65 mmHg, y tercil 3, 3 66 mmHg. En relación con el tercil 1, los del tercil 3 son más viejos (p < 0,001) y presentan cifras de PAS más elevadas (p < 0,001). El tercil 3 se asocia con mayor prevalencia de hipertensión arterial, hipertensión sistólica aislada y peor control de la hipertensión, así como con una mayor prevalencia de cardiopatía isquémica (p = 0,018) y de patología cardiovascular global (p = 0,005). Tras el análisis de regresión logística la presión de pulso persistió como variable independiente (p = 0,017).

Conclusiones: En población general anciana la presión de pulso es un marcador de riesgo cardiovascular independiente.

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