Central Pulse Pressure and Atherosclerotic Alterations of Coronary Arteries

Central pulse pressure is more likely to reflect the haemodynamic conditions to which the heart and coronary arteries are subjected than is peripheral pulse. We reviewed the data currently available on the correlations between central pulse pressure and both the presence and extent of coronary artery disease, as well as clinical outcomes. Five clinical studies have reported an association between central pulse pressure and the presence of coronary artery disease documented by coronary angiography. Four studies, including three of the previous ones, also found a correlation between central pulse pressure and the extent of coronary artery disease. In one of these studies, however, the correlation was present only in men, whereas no link was found between pulse pressure and coronary artery disease in women. After coronary angioplasty, increased central pulse pressure has been found correlated with the occurrence of restenosis after balloon angioplasty, but not after stent implantation. Finally, the ASCOT-CAFE trial found a positive correlation between pulse pressure and the occurrence of cardiovascular events, confirming the prognostic significance of this parameter.