2020 Volume 3 Issue 2 Pages 37-42
Background：It is not clear whether pulse pressure (PP) is a predictor of incident cardiovascular events in treated hypertensives. We sought to examine whether brachial and central PP predict incident cardiovascular events in subjects in the Antihypertensives and Blood pressure of Central artery in Japan II study, which included 3,566 patients from 27 institutions. Methods：Brachial and central hemodynamics were evaluated with a semi-automatic tonometry device. The mean age was 66.0±10.9 years, and 50.6% of the subjects were men. The mean brachial and central PP were 60.0±14.5 and 50.4±15.2 mmHg, respectively. An incident cardiovascular event was defined as stroke, myocardial infarction, sudden cardiac death, or acute aortic dissection. We performed multivariable Cox regression analysis with incident cardiovascular events as a dependent variable, and brachial and central PP as independent variables. Results：The hazard ratio per 10-mmHg increase in brachial PP was 1.16 (95% confidence interval [CI] 0.97-1.39, p=0.11) and that per 10-mmHg increase in central PP was 1.17 (95% CI 0.99-1.39, p=0.07). The relationship remained insignificant even when PP was divided by quintiles. The spline curve between brachial or central PP and the relative incidence of cardiovascular events showed a sigmoid relationship. Linear relationships were seen only in the range of 50-70 mmHg in brachial PP and 40-60 mmHg in central PP. Conclusions：In treated hypertensive patients, brachial and central PP were not markers for incident cardiovascular events. These relationships were not linear, and PPs were associated with incident cardiovascular events only in a limited range.
