Relationship of pulse pressure index and carotid intima-media thickness in hypertensive adults

Abstract

Objective: To evaluate the relationship between pulse pressure index (PPI) and carotid intima-media thickness (CIMT). Method: Observational trial was design and 342 patients newly diagnosed as hypertension without anti-hypertensive therapy were enrolled. According to the cut-off value of CIMT, 342 participants were divided into normal (< 0.9mm) and increased CIMT groups (≥ 0.9mm). Baseline characteristics were compared, logistic regression analysis and receiver operating characteristic curve (ROC) were performed. Results: Approximately 34.2% of participants (n = 117) were with CIMT ≥ 0.9 mm and participants in increased CIMT group were more elderly. Diastolic blood pressure was lower in increased CIMT group than normal group (79.3 ± 10.8 mm Hg versus 83.8 ± 9.4 mm Hg, p < 0.001), whereas pulse pressure (PP) (59.3 ± 20.2 mm Hg versus 53.6 ± 15.5 mm Hg, p = 0.004) and PPI (0.43 ± 0.09 versus 0.38 ± 0.08, p < 0.001) were significantly higher in increased CIMT group. CIMTs were 1.11 ± 0.11 mm and 0.76 ± 0.12 in increased group and normal group respectively (p < 0.001). After adjusted for the traditional risk factors, only PPI was found an independent determinant for CIMT increase, and the odd ratio was 1.644 (95% interval confidence 1.280–2.112, p < 0.001). The ROC evaluations showed that area under the curve for PP to predict CIMT increase was 0.591 ± 0.034, and PPI was 0.664 ± 0.033. PPI was more powerful than PP in discriminating CIMT increase (p = 0.006). Conclusion: PPI is a valuable parameter for the preliminary screening of hypertensive patients who have an increased risk of atherosclerosis.

• Essential hypertension
• pulse pressure
• pulse pressure index

Declaration of interest

All authors declare that there is no conflict of interest.

This work was supported by the grants from the Technology Project Foundation of Guangdong Province, China (2009A030301004, 2011B031800021, 2011B061300034 and 2011B031800263), Guangdong Natural Science Foundation (S2012010009532), Guangdong Medical Research Foundation (B2011002), Cardiovascular medication grant of Guangdong Province (2011X25), Medical Scientific Research Grant of the Health Ministry of Guangdong province, China (B2011310 and A2012663).