Standardizing the comparison of systolic blood pressure vs. pulse pressure for predicting coronary heart disease.

Whether systolic blood pressure (SBP) or pulse pressure (PP) is more predictive of coronary heart disease remains controversial. The authors analyzed 6032 participants in the first National Health and Nutritional Examination Survey (NHANES I) followed up for an average of 16 years. Blood pressure was measured at baseline and coronary heart disease outcomes were determined from hospital or mortality records. Cox proportional hazard analyses were used to estimate the multivariate-adjusted relative risk (RR) for increases of 10 mm Hg or 1 SD in SBP and PP, and the RR associated with PP was greater than the RR associated with SBP when using an increase of 10 mm Hg. However, when using an increase of 1 SD, the RR associated with SBP was larger than for PP. Although both are predictors, the authors conclude that SBP has a larger RR than PP for coronary heart disease events.