Pulse pressure and coronary mortality in elderly men and women from general population

Casíglia, Edoardo; Tikhonoff, Valérie; Mazza, Alberto; Piccoli, Antônio; Pessina, Achille C.

doi:10.1038/sj.jhh.1001461

Cited by 45 publications

(57 citation statements)

References 35 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The increase of pulse pressure (the pulsatile component of blood pressure) is an age-related phenomenon and the common belief is that it is an indicator of large artery stiffness [18] and an established marker of cardiovascular risk in different clinical settings [19,20]. High pulse pressure may derive both from a rise in systolic values and from a decrease in diastolic values.…”

Section: Discussionmentioning

confidence: 99%

Fixed-Dose Triple Combination of Antihypertensive Drugs Improves Blood Pressure Control: From Clinical Trials to Clinical Practice

et al. 2017

View full text Add to dashboard Cite

Introduction: Blood pressure (BP) control is the main clinical goal in the management of hypertensive patients; however, BP in most of these patients remains uncontrolled, despite the widespread availability of antihypertensive drugs as free-combination therapy. This study compared the efficacy of a fixed-dose triple combination (FDTC) of antihypertensive drugs with that of a free combination of three antihypertensives in patients with uncontrolled hypertension.

show abstract

Section: Discussionmentioning

confidence: 99%

Fixed-Dose Triple Combination of Antihypertensive Drugs Improves Blood Pressure Control: From Clinical Trials to Clinical Practice

et al. 2017

View full text Add to dashboard Cite

show abstract

“…This finding highlights the importance of using pulse pressure at an early stage of hypertension as a risk stratification tool, because pulse pressure-as opposed to SBP and DBP alone-has been shown to be a better predictor for adverse outcomes, especially in women. 18 Data from previous large hypertension trials have shown that most patients need combination therapy Figure 6 Blood pressure (BP) control rates for guideline-recommended dual therapies (percentage with 95% CI, adjusted for age, diabetes and ethnicity; for abbreviations see Figure 5a; # Po0.05 for gender differences). to achieve sufficient BP control.…”

Section: Discussionmentioning

confidence: 99%

Antihypertensive drug therapy and blood pressure control in men and women: an international perspective

et al. 2009

View full text Add to dashboard Cite

Cardiovascular death represents the single largest cause of mortality in women with 70% of deaths attributable to modifiable risk factors, such as hypertension. This analysis aims at evaluating, whether there are gender disparities in antihypertensive drug usage and blood pressure (BP) control. We included 18 017 patients with arterial hypertension from the International Survey Evaluating Microalbuminuria Routinely by Cardiologists in patients with Hypertension (I-SEARCH). The study was conducted between September 2005 and March 2006 in 26 countries, and data on patient demographics, cardiovascular disease and risk factors, BP, and cardiovascular drug treatment were collected. Mean systolic blood pressure (SBP) was 2.1 mm Hg higher in women (150.6 ± 0.35 mm Hg, n ¼ 8357/18 017) than in men (148.5 ± 0.35 mm Hg; Po0.0001, n ¼ 9526/18 017), whereas no difference in diastolic BP was seen (88.2 ± 0.20 vs 88±0.20 mm Hg; P ¼ 0.198). Gender differences in SBP were more pronounced in diabetic as compared with nondiabetic patients (3.5 vs 1.7 mm Hg, n ¼ 4272 vs n ¼ 13 611; Po0.0001) and became evident at an age 55 years old. Overall BP-control rate was 33.6% in men and 30.6% in women (Po0.0001) and was lower in diabetic as compared with non-diabetic patients. In all, 30% of patients used one, 40% used two and 30% used X3 drugs without gender differences. Response rates to different drug regimens appeared to be similar. However, women received more frequently thiazides and b-blockers, and less frequently ACE-inhibitors as monotherapy. Major efforts are required to improve BP-management, especially in women.

show abstract

“…[1][2][3][4][5] However, several studies have shown that awareness of hypertension and BP control is still suboptimal, 1 and thus effective strategies should be developed to improve BP control and adherence to therapy. One of the methods used to achieve these goals is represented by self-measurement of BP at home by automatic devices.…”

mentioning

confidence: 99%

Poor Reliability of Wrist Blood Pressure Self-Measurement at Home

et al. 2016

View full text Add to dashboard Cite

Blood pressure (BP) independently predicts cardiovascular risk in affluent countries. [1][2][3][4][5] However, several studies have shown that awareness of hypertension and BP control is still suboptimal, 1 and thus effective strategies should be developed to improve BP control and adherence to therapy. One of the methods used to achieve these goals is represented by self-measurement of BP at home by automatic devices. Many studies have shown that BP self-measurement at home allows a better BP control in hypertension and has a greater prognostic value than office BP. 6,7 In addition, self BP measurement is more appealing to the patient than the customary procedure in the physician's surgery often causing long waits. Upper-arm automatic devices gave fresh impetus to home self-measurement because of their user friendliness, 8 the only conditions to be respected being adequate cuff dimensions and correct positioning of the cuff on the patient's arm. [9][10][11][12][13][14] For reasons of market penetration and following a general tendency to miniaturization, many wrist devices recently appeared on the market 15 having the advantage of being smaller and easier to fit than upper-arm monitors, 16 and today wrist devices are used by a large portion of people who measure their BP at home. 17 However, in spite of technical improvement, their reliability in real-life conditions is not unanimously accepted. [18][19][20] Accuracy of BP measurement at wrist largely depends on the difference in height between the wrist and the heart because of the confounding effect of the hydrostatic pressure caused by the limb blood column.21-23 Wrists kept at a higher level in comparison with the heart lead to a false lower, and wrists at a lower level lead to a false higher BP values. Very rarely do patients receive appropriate training from family doctors or other healthcare personnel. Instructions attached to commercial packages require a certain degree of personal discernment, i.e., a good cognitive pattern. Only a few models have a position sensor to verify that the wrist is placed properly at heart level, 24 but even for these devices, no study has evaluated their reliability in real-life conditions.The aim of the present study was to ascertain whether wrist home BP is performed reliably or an error is present in measurement, and to identify the determinants of this error if any.To verify the reliability of wrist BP self-measurement, we determined at a population level the upper-arm−wrist BP difference in the office under a doctor's supervision and then verified whether this difference was maintained during home self-measurement.Abstract-The reliability of blood pressure measurement with wrist devices, which has not previously been assessed under real-life circumstances in general population, is dependent on correct positioning of the wrist device at heart level. We determined whether an error was present when blood pressure was self-measured at the wrist in 721 unselected subjects from the general population. After training, blood p...

show abstract

Pulse pressure and coronary mortality in elderly men and women from general population

Cited by 45 publications

References 35 publications

Fixed-Dose Triple Combination of Antihypertensive Drugs Improves Blood Pressure Control: From Clinical Trials to Clinical Practice

Fixed-Dose Triple Combination of Antihypertensive Drugs Improves Blood Pressure Control: From Clinical Trials to Clinical Practice

Antihypertensive drug therapy and blood pressure control in men and women: an international perspective

Poor Reliability of Wrist Blood Pressure Self-Measurement at Home

Contact Info

Product

Resources

About