Association between pulse pressure and carotid plaque in elderly patients with uncontrolled hypertension: Results from a community-based screening Hangzhou, China

Abstract Objectives: There is a wider pulse pressure (PP) and a higher prevalence of carotid plaques in the elderly. Previous studies indicated PP is strongly associated with carotid plaques formation. This study aimed to explore this association in elderly patients with uncontrolled hypertension. Materials and Methods: 1671 hypertensive patients aged ≥ 60 years with uncontrolled hypertension were enrolled from a community-based screening in Hangzhou, China. Carotid plaques were assessed using ultrasonography. Logistic regression models were used to estimate the association between PP and carotid plaques by odds ratios (ORs) and 95% confidence intervals (CIs). Results: Carotid plaques were detected in 780 (46.7%) of subjects. Of them, plaques ≥ 2 was found in 415 (53.1%). There was a significant positive association between the PP tertile levels and the prevalence of carotid. After adjustment for traditional risk factors, compared to patients within the lowest tertile of PP, those within the highest tertile had an increased risk of carotid plaques (OR 1.641, CI 1.152–2.337). For each 1-SD increase, the risk increased by 38.4% (OR 1.384, CI 1.134–1.688). There was a non-linear association between PP and carotid plaques (P-nonlinearity= 0.029). The risk increased rapidly after the predicted PP level reached at around 70 mmHg. Conclusions: Our findings suggested that PP was independently associated with carotid plaques in elderly patients with uncontrolled hypertension who have an increased risk of atherosclerosis.