Pulse Pressure Index as an Indicator of Risk for Cardiovascular Disease, Chronic Kidney Disease, and Diabetes Mellitus in Korean Adults with Hypertension: the 8th Korea National Health and Nutrition Examination Survey, 2019–2021

Background: Pulse pressure, reflecting arterial wall stiffness, is a cardiovascular disease risk factor but is highly variable.This study investigated the association of the pulse pressure index (PPI) with 10-year cardiovascular disease risk and its clinical utility by examining its correlations with diabetes mellitus (DM) and chronic kidney disease (CKD).Methods: This cross-sectional study included 3,604 hypertensive adults (30-79 years) from the 2019-2021 Korea National Health and Nutrition Examination Survey.We categorized PPI as <30, 30 to 40, 40 to 50, and ≥50.The Framingham risk score assessed 10-year cardiovascular disease risk, and multiple regressions analyzed its relationship with the PPI category.Binary logistic regressions evaluated the relationship between PPI, DM, and CKD.Results: Adjusted for other variables, higher PPI levels are associated with an increased 10-year cardiovascular disease risk (P<0.001).PPI ≥50 was associated with CKD, and all PPI groups, except <30, were associated with DM.Conclusion: PPI predicts 10-year CVD risk and is associated with DM presence.PPI can be considered a risk factor for both cardiovascular disease and DM.Additionally, PPI ≥50 is associated with CKD.