SUMMARYThe significance of pulse pressure (PP) and mean blood pressure (MBP) for blood pressure (BP) control is unclear. The aim of this study was to examine the relationship between PP and MBP and BP control.We obtained home BP measurements for 117 patients aged 40-75 years with either office systolic BP (SBP) ≥ 140 mmHg or office diastolic BP (DBP) ≥ 90 mmHg. Patients were treated with 1 to 2 antihypertensive drugs for 6 months to achieve home SBP < 135 mmHg and home DBP < 85 mmHg.At follow-up, 72 patients were taking a single drug with good BP control, 23 were taking two drugs with good BP control, and 22 were taking two drugs without good BP control. Although office SBP and DBP at baseline were similar in the three groups, home SBP and DBP at baseline in the single drug group were lowest among the three groups (P < 0.01). Home MBP at baseline in the single drug group was lowest among the three groups (P < 0.01). Home PP at baseline was highest in the two-drug without good control group (P < 0.001). In multivariate logistic regression analysis, only home MBP at baseline was significantly correlated with a lack of BP control.Home MBP rather than home PP is associated with achieving adequate BP control. (Int Heart J 2005; 46: 691-699) Key words: Hypertension, Pulse pressure, Mean blood pressure, Home blood pressure measurement ELEVATED blood pressure (BP) acts in arteries as an injuring mechanical force, which may contribute to the development of atherosclerosis and to an increase in cardiovascular risk. The current guidelines for the management of hypertension rest almost completely on the measurement of systolic BP (SBP) and diastolic BP (DBP), 2 specific inflection points of the BP wave, which are usually considered in isolation.1,2) However, BP propagates through the arterial tree as a repetitive continuous wave and is more accurately described as consisting of a pulsatile component (pulse pressure, PP) and a steady component (mean BP, MBP).
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