The steady component of blood pressure was a strong prognostic factor for cardiovascular death in both sexes, while the pulsatile component was an independent risk factor in women over 55 years.
Cohort (n=27,687)
Do the steady and pulsatile components of blood pressure predict cardiovascular mortality in adults aged 40-69 years?
The steady component of blood pressure (mean arterial pressure) is a strong predictor of cardiovascular death in both sexes, while the pulsatile component (pulse pressure) provides independent prognostic value in older women.
Studies on the prognostic significance of blood pressure on cardiovascular disease have essentially investigated the levels of diastolic or systolic blood pressure. However, blood pressure may also be divided into two other components: steady (mean arterial pressure) and pulsatile (pulse arterial pressure). The relations of these two components with cardiovascular risk factors and cardiovascular mortality were investigated in 18,336 men and 9,351 women aged 40-69 years, who were followed up for a mean period of 9.5 years. However, the interpretation of the relations is complicated by the strong correlation existing between these two components. A principal component analysis was performed to obtain two independent parameters: a steady and a pulsatile component index, strongly correlated with mean and pulse arterial pressure, respectively. In the cross-sectional analysis, relations were stronger with the steady component index than with the pulsatile component index; an association was found between left ventricular hypertrophy and the pulsatile component index in both sexes. The survival analysis was not performed in women under 55 as only 11 cardiovascular deaths occurred in this group. The steady component index was a strong prognostic factor of all types of cardiovascular death in both sexes. In women, the pulsatile component index was positively correlated to death from coronary artery disease and inversely correlated to stroke. In conclusion, the steady component of blood pressure is a strong risk factor for cardiovascular death in both sexes; the pulsatile component could be a risk factor independent of the steady component in women older than 55 years.
Darné et al. (1989) conducted a cohort in Cardiovascular mortality (n=27,687). Steady and pulsatile components of blood pressure was evaluated on Cardiovascular mortality. The steady component of blood pressure was a strong prognostic factor for cardiovascular death in both sexes, while the pulsatile component was an independent risk factor in women over 55 years.