Association Between Pulse Pressure and Subclinical Carotid Atherosclerosis in Normotensive and Hypertensive Post-Menopausal Women

Abstract

Pulse pressure, the difference between systolic blood pressure and diastolic blood pressure, is associated with cardiovascular diseases. Several studies showed that a large pulse pressure is an independent predictor of cardiovascular mortality since the increased stiffness augment ascending aortic pulse pressure that, in turn, produce wall stress and development of atherosclerosis. A sample of 252 post-menopausal women underwent a clinical evaluation and carotid artery ultrasound examinations. We measured carotid intimal media thickness—a well-known atherosclerosis marker. For statistical analysis an unpaired student-test and a one-way ANOVA to compare means between the groups and a chi-square test to compare the prevalence of variables among the groups were used. Multivariate linear regression analysis was used to adjust for confounding variables. The carotid intimal media thickness (IMT) was significantly associated to pulse pressure in post-menopausal women. The statistically significant association was confirmed after adjustment for age, blood pressure, cholesterol, and trygliceride levels. Indeed, after subdivision in tertiles of pulse pressure, the IMT in the third pulse pressure tertile was significantly higher than in the first tertile. A large pulse pressure is an independent risk factor for carotid atherosclerosis in post-menopausal women. The pulse pressure could predispose to atherosclerosis influencing the nitrix oxide (NO) release or representing an injury to the arterial wall. Clinical trials are requested to assess whether a treatment aimed at reducing the pulse pressure could better prevent cardiovascular and cerebrovascular disease in these subjects.