Coccina Francesca, Pierdomenico Anna M, Cuccurullo Chiara, Pizzicannella Jacopo, Trubiani Oriana, Pierdomenico Sante D
Department of Innovative Technologies in Medicine & Dentistry, University "Gabriele d'Annunzio", Chieti-Pescara, 66100 Chieti, Italy.
Department of Medicine and Aging Sciences, University "Gabriele d'Annunzio", Chieti-Pescara, 66100 Chieti, Italy.
Diagnostics (Basel). 2023 Feb 23;13(5):845. doi: 10.3390/diagnostics13050845.
(1) Background: The aim of this study was to assess the prognostic impact of 24-hour pulse pressure (PP), elastic PP (elPP) and stiffening PP (stPP) in elderly treated hypertensive patients; (2) Methods: In this retrospective study, we evaluated 745 treated hypertensive subjects older than 65 years who underwent ambulatory blood pressure monitoring to assess 24-hour PP and 24-hour elPP and stPP, as calculated by a mathematical model. The association of these PP components with a combined endpoint of cardiovascular events was investigated; (3) Results: The 24-hour PP, elPP and stPP were 59 ± 12.5, 47.5 ± 9.5 and 11.5 ± 6.5 mmHg, respectively. During the follow-up (mean 8.4 years), 284 events occurred, including coronary events, stroke, heart failure hospitalization and peripheral revascularization. In the univariate Cox regression analysis, 24-hour PP, elPP and stPP were associated with the combined outcome. After the adjustment for covariates, per one standard deviation increase, 24-hour PP had a borderline association with risk (hazard ratio (HR) 1.16, 95% confidence interval (CI) 1.00-1.34), 24-hour elPP remained associated with cardiovascular events (HR 1.20, 95% CI 1.05-1.36) and 24-hour stPP lost its significance. (4) Conclusions: 24-hour elPP is a predictor of cardiovascular events in elderly treated hypertensive patients.
(1) 背景：本研究旨在评估24小时脉压（PP）、弹性脉压（elPP）和硬化脉压（stPP）对老年高血压患者预后的影响；(2) 方法：在这项回顾性研究中，我们评估了745名年龄大于65岁的接受治疗的高血压患者，这些患者接受了动态血压监测，以评估24小时PP以及通过数学模型计算得出的24小时elPP和stPP。研究了这些PP成分与心血管事件综合终点的关联；(3) 结果：24小时PP、elPP和stPP分别为59±12.5、47.5±9.5和11.5±6.5 mmHg。在随访期间（平均8.4年），发生了284起事件，包括冠心病事件、中风、心力衰竭住院和外周血管重建。在单因素Cox回归分析中，24小时PP、elPP和stPP与综合结局相关。在对协变量进行调整后，每增加一个标准差，24小时PP与风险存在临界关联（风险比（HR）1.16，95%置信区间（CI）1.00 - 1.34），24小时elPP仍与心血管事件相关（HR 1.20，95% CI 1.05 - 1.36），而24小时stPP失去了其显著性。(4) 结论：24小时elPP是老年高血压患者心血管事件的一个预测指标。
