Abstract

Emerging evidence suggests that pulse pressure is an independent predictor of risk for cardiovascular mortality. New studies in diverse populations are needed to further establish the applicability of this finding. Thus, the purpose of this study is to examine the relationship between pulse pressure and cardiovascular mortality in a cohort of Puerto Rican men after 12 years of follow-up. The Puerto Rico Heart Health Program is a study of coronary disease risk factors in men aged 35-79 years at baseline who had an initial examination during the years 1962-1965. It was attended by 9824 subjects representing 80% of the total age-specific male residents in 4 rural and 3 urban areas of Puerto Rico. Cardiovascular risk factors including systolic and diastolic blood pressures were monitored prospectively. This study includes 9106 men free of overt CHD at baseline who were stratified by quartiles of pulse pressure in mmHg: quartile 1, <or=38, quartile 2, 39-46; quartile 3, 47-56; and quartile 4, >or=57. The odds ratio of cardiovascular mortality was calculated using logistic regression analysis. After adjusting for age, education, smoking status, hypercholesterolemic status, physical activity, diabetic status and mean arterial pressure, we found that those in the highest quartile of pulse pressure (pulse pressure>=57) had significantly higher cardiovascular mortality than those in the lowest quartile (reference group) (OR=1.38 95% CI=1.01-1.88). Our findings showed that a wide pulse pressure is independently associated with cardiovascular mortality in this group of Puerto Rican men.

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