Elevated pulse pressure (PP) is one of the hallmarks of the metabolic syndrome (MS) and predicts the risk for heart disease in elderly women. This research finding is based on the study conducted by an Italian team of researchers led by A. Mazza at the General hospital Rivogo, Italy.

Pulse Pressure

A.Mazza and his team of researchers evaluated the definition of hypertension that was most closely associated with coronary mortality in elderly MS patients.

The study, by A Mazza at the “General Hospital Rivogo, Italy” and team, included 3282 patients aged 65 years and older who were participating in the Cardiovascular Study in the ‘Elderly CASTEL’. This study was actually a longitudinal epidemiological survey involving a representative sample of the elderly population.

The MS was diagnosed using the ‘National Education Cholesterol Program Adult Treatment Panel III’ criteria but with three different definitions of hypertension. These definitions included systolic blood pressure (SBP) with more than or equal to 130 and diastolic blood pressure (DBP) with more than or equal to 85 mmHg, SBP with more than or equal to 130 or DBP with more than or equal to 85 mmHg, and PP with more than or equal to75 mmHg in men and equal to 80 mmHg in women.

A. Mazza and his team then analyzed which of the three MS definitions was most strongly associated with mortality from coronary heart disease (CHD) over 12 years of follow-up.
Researchers observed that none of the definitions predicted CHD mortality in elderly men. The authors reported in the “Journal of Human Hypertension” that among the elderly women with untreated hypertension, CHD mortality was always higher in women with the MS in comparison to those who were without MS. The ‘hazard ratios (HR)’ in these cases were 1.73, 1.75, and 2.37 using all the three definitions respectively.

Researchers also observed a contrast, CHD mortality in women receiving antihypertensive therapy was increased only in women with the MS according to the third definition with a hazard ratio of 1.92.PP was therefore the strongest predictor of CHD mortality in elderly women with the MS.

“The role of hypertension as a factor influencing CHD risk in subjects with MS is under debate, particularly in the elderly“, the study authors’ remark, adding that some believe hypertension is associated with the MS only as a secondary phenomenon.

“MS seems to have the same predictive role as high PP,” they write. “Nevertheless, as a ‘MS world’ will still continue to exist for some time yet, it might be advisable to employ PP as the BP criterion for definition hypertension in MS“.

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