What question did this study set out to answer?

Determine whether systolic blood pressure (SBP) or pulse pressure (PP) is a stronger predictor of coronary heart disease events when using standardized metrics.

June 1, 2006Journal of Clinical HypertensionOpen Access

Standardizing the Comparison of Systolic Blood Pressure vs. Pulse Pressure for Predicting Coronary Heart Disease

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Why the study?

Does an increase in systolic blood pressure predict coronary heart disease better than an increase in pulse pressure in adults aged 25-74?

Key Points

Determine whether systolic blood pressure (SBP) or pulse pressure (PP) is a stronger predictor of coronary heart disease events when using standardized metrics.
Analyzed 6,032 participants from the NHANES I cohort with baseline blood pressure measurements and an average follow-up of 16 years.
Identified coronary heart disease outcomes through linkage to hospital records and mortality registries.
Applied multivariate-adjusted Cox proportional hazards models to calculate relative risk (RR) increments per 10 mm Hg and per 1 standard deviation (SD) for both SBP and PP.
Per 10 mm Hg increase, the multivariate-adjusted relative risk was greater for pulse pressure than for systolic blood pressure.
Per 1 standard deviation increase, systolic blood pressure demonstrated a larger relative risk for coronary heart disease events than pulse pressure.

Structured PICO

Does an increase in systolic blood pressure predict coronary heart disease better than an increase in pulse pressure in adults aged 25-74?

Population

6,032 participants aged 25-74 years old at baseline from the first National Health and Nutrition Examination Survey (NHANES I) Epidemiologic Follow-up Study, without a history of coronary heart disease at baseline.

Intervention

Increase in systolic blood pressure (SBP) evaluated by 10 mm Hg or 1 standard deviation (SD)

Comparator

Increase in pulse pressure (PP) evaluated by 10 mm Hg or 1 standard deviation (SD)

Outcome

Coronary heart disease (CHD) events identified by hospital discharge summary (ICD-9 codes 410-414) or death certificates over an average 16 years follow-uphard clinical

When standardized by a 1 standard deviation increase rather than a 10 mm Hg absolute increase, systolic blood pressure is a stronger predictor of coronary heart disease than pulse pressure across age groups.

Limitations

Possible bias due to loss to follow-up or hospital record classification

Discussion

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Implication

SBP may better predict CHD than PP with standardized increments across ages; leaves open impact on guideline risk assessment.

Cite This Study

Davidson et al. (2006) studied this question.

synapsesocial.com/papers/6a77b36ad8eb58afc2be0e59 https://doi.org/10.1111/j.1524-6175.2006.05368.x

Topics

Hypertension management

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Standardizing the Comparison of Systolic Blood Pressure vs. Pulse Pressure for Predicting Coronary Heart Disease

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Topics

Standardizing the Comparison of Systolic Blood Pressure vs. Pulse Pressure for Predicting Coronary Heart Disease

Key Points

Structured PICO

Limitations

Discussion

Implication

Cite This Study

Also Consider

Topics

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