Source
Geriatric Ward, Rabin Medical Center, Petah Tikvah, Israel. avrahamw@clalit.org.il
Abstract
BACKGROUND:
Pulse pressure (PP) values increase with age. The impact of PP on mortality in elderly patients has not been established.
OBJECTIVES:
To evaluate the effect of PP on mortality among very elderly hospitalized patients.
DESIGN:
A prospective clinical study.
PARTICIPANTS AND MEASUREMENTS:
The medical records of 420 inpatients aged >60 (187 males, mean age of 81.4 +/- 7 years) hospitalized in an acute geriatric ward were reviewed. Patients were followed up for a mean of 3.46 +/- 1.87 years. Mortality data were extracted from death certificates. Using relative operating characteristic (ROC) curves, we identified PP of 62.5 mmHg as a cutoff point. Subjects were categorized as having low PP (< or = 62.5 mmHg; N = 116) or high PP (>62.5 mmHg; N = 304).
MAIN RESULTS:
The mortality rate was greater in patients with high PP than in those with low PP. During the follow-up, 201 patients died, 155 patients (51%) in the high PP group and 46 patients (39.7%) in the low PP group (p = 0.038). Pulse pressure was associated with all-cause mortality (HR = 1.69, 95% CI = 1.19-2.38, p = 0.003) even after controlling for gender, age, diabetes mellitus, atrial fibrillation and heart rate.
CONCLUSION:
High PP is an independent predictor of mortality among elderly hospitalized patients.