Cardiovascular risks related to increased diastolic, systolic and pulse pressure. An epidemiologist's point of view.

摘要: Since the introduction of sphygmomanometer at beginning to 20th century, significance diastolic (DBP), Systolic (DBP) and pulse pressure (PP) as hypertensive cardiovascular risk factors has been controversial. These historical controversies are reviewed. Initially, DBP was thought be best measure risk, but more recently both SBP DBP, which ever is higher, used in classifying risk. There problems with present guidelines, that represent only two inflection points on propagated wave measured by cuff readings peripheral brachial artery. The heart exposed central aortic not artery pressure. Moreover, vascular resistance large stiffness contribute In middle-aged elderly, elevated a better surrogate measurement than underestimates stiffness. PP, difference between peak end single blood for Epidemiological studies over past decade point markers young subjects, whereas PP takes powerful marker elderly subjects. findings support concept events related pulsatile stress during systole steady-state small vessel diastole. Therefore, similar elevations SBP, subjects isolated systolic hypertension greater those combined systolic/diastolic hypertension.