Pulse pressure in older patients with systolic hypertension linked to heart failure

מתוך medicontext.co.il

WESTPORT, CT (Reuters Health) – The results of a recent study suggest that high pulse pressure is associated with an increased risk of heart failure in older patients with isolated systolic hypertension, independently of arterial pressure.

Dr. John B. Kostis, of UMDNJ-Robert Wood Johnson Medical School, New Brunswick, New Jersey, and colleagues analyzed data on 4736 participants in the Systolic Hypertension in the Elderly Program (SHEP). At baseline all were at least 60 years of age with systolic blood pressure between 160 and 219 mm Hg and diastolic blood pressure less than 90 mm Hg.

One hundred sixty patients experienced fatal or nonfatal heart failure over an average followup of 4.5 years, according to the team's report in the August issue of the American Journal of Hypertension. Systolic blood pressure, pulse pressure, and mean arterial pressure strongly predicted the development of heart failure (p < 0.0002).

After adjustment for mean arterial pressure, "heart failure was inversely related to diastolic blood pressure (p = 0.002) and was directly related to pulse pressure (p = 0.002)," according to the investigators. "Data were similar when patients who developed myocardial infarction during followup were excluded."

The findings confirm those from other studies, including other analyses of SHEP data, Dr. Kostis and colleagues note. "Whether different classes of pharmacotherapy will have different effects on event reduction according to differential effect on lowering pulse pressure remains speculative," they say.

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