Effect of Aging on the Prognostic Significance of Ambulatory Systolic, Diastolic, and Pulse Pressure in Essential Hypertension

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Abstract
Background This study compared the relative prognostic significance of 24 hour intra-arterial ambulatory systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and pulse pressure (PP) parameters in middle-aged versus elderly hypertensives. Methods and Results A total of 546 subjects aged P =0.04) but not SBP (z=−0.43, P =0.67) was related to outcome in younger subjects, whereas in the elderly group, SBP (z=3.33, P =0.001) was positively and DBP (z=−1.75, P =0.07) was negatively related to outcome. Clinic blood pressure measurements failed to provide any independent prognostic value in either age group. Conclusions The relative prognostic significance of ambulatory blood pressure components depends on age; DBP parameters provided the best prognostic value in middle-aged individuals, whereas PP parameters were the most predictive in the elderly. This may reflect differing underlying hemodynamic mechanisms of hypertension in these age groups.