Is pulse pressure a better predictor of risk?
One reason DBP cannot be ignored is that recently pulse pressure (PP), defined as the difference between SBP and DBP, has received some attention as an independent predictor of cardiovascular risk.12,19,20,21 With age, as SBP rises and DBP stabilizes or falls, and thus, PP widens. Mechanistically, this is thought to be due to an increase in large artery stiffness and the increased amplitude of reflection of the wave caused by ventricular ejection.4 Pulse waves are generated in the left ventricle and the great vessels during systole. In the presence of aortic stiffness, the pulse waves reflect more quickly off the peripheral resistance vessels. Therefore instead of the pulse waves returning during diastole and augmenting DBP, they reach the large vessels during late systole, increasing SBP and widening pulse pressure.22 In the Framingham study, amongst the middle-aged and elderly, the cardiovascular risk was inversely related to DBP at any given SBP over 120 mm Hg. Furthermore, there wa
One reason DBP cannot be ignored is that recently pulse pressure (PP), defined as the difference between SBP and DBP, has received some attention as an independent predictor of cardiovascular risk.12,19,20,21 With age, as SBP rises and DBP stabilizes or falls, and thus, PP widens. Mechanistically, this is thought to be due to an increase in large artery stiffness and the increased amplitude of reflection of the wave caused by ventricular ejection.4 Pulse waves are generated in the left ventricle and the great vessels during systole. In the presence of aortic stiffness, the pulse waves reflect more quickly off the peripheral resistance vessels. Therefore instead of the pulse waves returning during diastole and augmenting DBP, they reach the large vessels during late systole, increasing SBP and widening pulse pressure.22 In the Framingham study, amongst the middle-aged and elderly, the cardiovascular risk was inversely related to DBP at any given SBP over 120 mm Hg. Furthermore, there wa
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