Association of pulse pressure and CVD Incidence rate: a cohort study of a Chinese population

Abstract

Background Pulse blood pressure was significantly associated with cardiovascular mortality in middle-aged and elderly populations, but less evidence was known for the incidence of cardiovascular diseases. Objective The aim of this stusy was to assess the association of pulse pressure (PP) with the incident risks of cardiovascular disease in all populations,and to further evaluate relationships of pulse pressure and blood pressure, jointly, with the incidence of cardiovascular diseases. Method A total of 13,489 participants from the Zhejiang Metabolic Syndrome cohort was recruited. Pulse pressure was defined as the difference between the systolic blood pressure (SBP) and diastolic blood pressure (DBP), and participant pulse pressure levels were categorized into two groups : normal PP(<60 mmHg) and high PP (≥ 60 mmHg). Cox proportional hazards models was performed to estimate the hazard ratio (HR) and its 95% CI for the incidence of CVD, adjusted for the potential confounding factors. Results After a median of follow-up of 10.03 years, 1466 CVD events (10.9%) were observed in the cohort. The HRs of CVD were significantly positively correlated with PP. After adjusting for age, sex, smoking, drinking, BMI, HR, TG, LDL-C, FPG, Lipid-lowering drugs, Hypoglycemic agent and baseline hypertension with a multiple Cox regression model, subjects with PP ≥ 60mmHg group showed the higher risk of CVD, with a HR of 1.220 (95% CI 1.084 to 1.373). Conclusion PP ≥ 60 mmHg was significantly associated with an increased risk of CVD in all populations. Hypertension subjects with pulse pressure over 60mmHgshould be given more attention in the prevention of CVD and control of pulse pressure, especially in women. Further studies are needed to corroborate these findings.