ABSTRACT
INTRODUCTION: Arterial hypertension and aging are the main cardiovascular risk factors (CVRF) in the elderly population. Aging is associated with an increase in systolic blood pressure (SBP) levels and a decrease of diastolic blood pressure (DBP), due to increased large artery stiffness. Several epidemiological studies have demonstrated that pulse pressure (PP) is an independent risk factor, better than SBP, for overall, cardiovascular mortality, coronary heart disease and cerebrovascular, particularly in the elderly. OBJECTIVES: To determine the association of PP with clinical cardiovascular damage, in a population-based sample of Spanish elders subjects. To quantify the association between PP and the background of clinical cardiovascular damage. To determine which PP, SBP, DBP or mean arterial pressure (MAP) are better associated to the history of clinical cardiovascular damage. PATIENTS AND METHODS: The sample analyzed included individuals from the EPICARDIAN study in the areas of Lista district (Madrid) and Arévalo (Avila). The following CVRF of age, gender, hypertension, diabetes, dyslipidemia, obesity, abdominal obesity and smoking were considered. Clinical cardiovascular damage is defined as the personal background of stroke, myocardial infarction, angina pectoris and/or intermittent claudication. RESULTS: The sample included 2665 individuals, 56% women, mean age: 74 year-old; 74.3% were hypertensive, 55.6% had central obesity and 31.9% hypercholesterolemia. In the multivariate analysis, the PP was the BP parameter associated most to stroke, angina pectoris and intermittent claudication: OR, 1.015, (95% CI: 1.001-1.030), 1.029 (95% CI: 1.006-1.052) and 1.012 (95% CI: 1.002-1.023), respectively. CONCLUSIONS: In the elderly population studied, an elevated PP is the component of arterial pressure with the greatest association to the background of cardiovascular damage.
Subject(s)
Cardiovascular Diseases/epidemiology , Hypertension/epidemiology , Aged , Aged, 80 and over , Aging , Blood Pressure , Female , Humans , Male , Risk FactorsABSTRACT
Introducción. La hipertensión arterial y la edad son los factores de riesgo cardiovasculares (FRCV) principales en la población anciana. Con la edad existe un incremento en los niveles de presión arterial sistólica (PAS) y un descenso de la presión arterial diastólica (PAD) debido a la rigidez arterial de las grandes arterias. Numerosos estudios epidemiológicos han demostrado que la presión de pulso (PP) es un factor de riesgo independiente, mejor que la PAS, de mortalidad global, cardiovascular, enfermedad coronaria y cerebrovascular, sobre todo en población anciana. Objetivos. Determinar la asociación entre la PP con el antecedente de enfermedad cardiovascular clínica en una muestra poblacional de ancianos españoles. Determinar si la PP se asocia mejor que la PAS, PAD y presión arterial media (PAM) con el antecedente de daño cardiovascular clínico. Pacientes y métodos. Los datos empleados han sido obtenidos de una muestra del proyecto EPICARDIAN pertenecientes al barrio de Lista (Madrid) y Arévalo (Ávila). Se consideraron los siguientes FRCV: edad, sexo, hipertensión, diabetes, hipercolesterolemia, obesidad, obesidad abdominal y tabaquismo. Se definió enfermedad cardiovascular clínica a los antecedentes de accidente cerebrovascular (ACV), infarto agudo de miocardio (IAM), angina y/o claudicación intermitente. Resultados. Se estudiaron 2.665 sujetos (56% mujeres), edad media: 74 años. El 74,3% eran hipertensos, el 55,6% presentaban obesidad central y el 31,9% hipercolesterolemia. De los cuatro componentes de PA, la PP elevada fue el parámetro que más se asoció a ACV, angina y claudicación intermitente: odds ratio en el análisis multivariado de 1,015 (intervalo de confianza del 95% [IC 95%]: 1,001-1,030), 1,029 (IC 95%: 1,006-1,052) y 1,012 (IC 95%: 1,002-1,023), respectivamente. Conclusiones. En la población anciana estudiada la PP es el parámetro de la PA que muestra una mayor asociación con el antecedente de enfermedad cardiovascular (AU)
Introduction. Arterial hypertension and aging are the main cardiovascular risk factors (CVRF) in the elderly population. Aging is associated with an increase in systolic blood pressure (SBP) levels and a decrease of diastolic blood pressure (DBP), due to increased large artery stiffness. Several epidemiological studies have demonstrated that pulse pressure (PP) is an independent risk factor, better than SBP, for overall, cardiovascular mortality, coronary heart disease and cerebrovascular, particularly in the elderly. Objectives. To determine the association of PP with clinical cardiovascular damage, in a population-based sample of Spanish elders subjects. To quantify the association between PP and the background of clinical cardiovascular damage. To determine which PP, SBP, DBP or mean arterial pressure (MAP) are better associated to the history of clinical cardiovascular damage. Patients and methods. The sample analyzed included individuals from the EPICARDIAN study in the areas of Lista district (Madrid) and Arévalo (Avila). The following CVRF of age, gender, hypertension, diabetes, dyslipidemia, obesity, abdominal obesity and smoking were considered. Clinical cardiovascular damage is defined as the personal background of stroke, myocardial infarction, angina pectoris and/or intermittent claudication. Results. The sample included 2665 individuals, 56% women, mean age: 74 year-old; 74.3% were hypertensive, 55.6% had central obesity and 31.9% hypercholesterolemia. In the multivariate analysis, the PP was the BP parameter associated most to stroke, angina pectoris and intermittent claudication: OR, 1.015, (95% CI: 1.001-1.030), 1.029 (95% CI: 1.006-1.052) and 1.012 (95% CI: 1.002-1.023), respectively. Conclusions. In the elderly population studied, an elevated PP is the component of arterial pressure with the greatest association to the background of cardiovascular damage (AU)
