%0 Journal Article
%T Higher pulse pressure and risk for cardiovascular events in patients with essential hypertension: The Campania Salute Network
%A Bruno Trimarco
%A Costantino Mancusi
%A Giovanni Albano
%A Giovanni de Simone
%A Grazia Canciello
%A Maria A Losi
%A Maria V Carlino
%A Nicola De Luca
%A Raffaele Izzo
%J European Journal of Preventive Cardiology
%@ 2047-4881
%D 2018
%R 10.1177/2047487317747498
%X Increased pulse pressure is associated with structural target organ damage, especially in elderly patients, increasing cardiovascular risk. In this analysis, we investigated whether high pulse pressure retains a prognostic effect also when common markers of target organ damage are taken into account. We analysed an unselected cohort of treated hypertensive patients from the Campania Salute Network registry (n£¿=£¿7336). Participants with available cardiac and carotid ultrasound were required to be free of prevalent cardiovascular disease, with ejection fraction ¡Ý50%, and no more than stage III Chronic Kidney Disease. The median follow-up was 41 months and end-point was occurrence of major cardiovascular events (i.e. fatal and non-fatal stroke or myocardial infarction and sudden death). Based on current guidelines, pulse pressure ¡Ý60£¿mm£¿Hg was classified as high pulse pressure (n£¿=£¿2356), at the time of the initial visit, whereas pulse pressure <60£¿mm£¿Hg was considered normal (n£¿=£¿4980). High pulse pressure patients were older, more likely to be women and diabetic, while receiving more antihypertensive medications than normal pulse pressure (all p£¿<£¿0.0001). High pulse pressure exhibited greater prevalence of left ventricular hypertrophy, and carotid plaque than normal pulse pressure (all p£¿<£¿0.0001). In Cox regression, high pulse pressure patients had 57% increased hazard of major cardiovascular events, compared to normal pulse pressure (hazard ratio£¿=£¿1.57; 95% confidence interval: 1.12¨C2.22, p£¿=£¿0.01), an effect that was independent of significant prognostic impact of older age, male sex, diabetes, left ventricular hypertrophy, carotid plaque and less prescription of anti-renin¨Cangiotensin system therapy. High pulse pressure is a functional marker of target organ damage, predicting cardiovascular events in hypertensive patients, even independently of well-known structural markers of target organ damage
%K Hypertension
%K target organ damage
%K pulse pressure
%K cardiovascular events
%K arterial stiffness
%U https://journals.sagepub.com/doi/full/10.1177/2047487317747498