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Clin Res Cardiol. 2016 Aug;105(8):677-86. doi: 10.1007/s00392-016-0972-2. Epub 2016 Feb 22.

Pulse pressure as an independent predictor of stroke: a systematic review and a meta-analysis.

Author information

1
Department of Neurology, Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, 639 Zhizaoju Road, Huangpu District, Shanghai, 200011, China.
2
Department of Neurology, Xixi Hospital of Hangzhou, Zhejiang University of Traditional Chinese Medicine, Hangzhou, 310023, China.
3
Department of Neurology, Henan Provincial People's Hospital, Zhengzhou, China. bingming6912@163.com.
4
Department of Neurology, Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, 639 Zhizaoju Road, Huangpu District, Shanghai, 200011, China. shuliang_9@hotmail.com.
5
Department of Neurology, Jiuyuan Municipal Stroke Center, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University, School of Medicine, 639 Zhizaoju Road, Huangpu District, Shanghai, 200011, China. liujr021@163.com.

Abstract

BACKGROUND:

Recent evidence suggests that pulse pressure (PP) is a strong cardiovascular diseases' risk factor. We systematically evaluated all relevant studies to determine whether PP can be used as an independent predictor of stroke and mortality.

METHODS AND RESULTS:

A meta-analysis was performed by searching the published literature using MEDLINE, Cochrane and Google Scholar databases up to December 15, 2015. We measured the effect size expressed by hazard ratio (HR) and 95 % confidence interval (95 % CI). Eleven publications were included in the analysis. Pooled results demonstrated that 10 mmHg increase in PP was associated with increased risk of stroke occurrence (pooled HR 1.046, 95 % CI 1.025-1.068, P < 0.001). Additionally, systolic blood pressure (SBP) (pooled HR 1.053, 95 % CI 1.033-1.073, P < 0.001) and diastolic blood pressure (DPB) (pooled HR 1.056, 95 % CI 1.038-1.074, P < 0.001) were found to be significant predictors for stroke. We did not find a significant association between PP and all-cause mortality (pooled HR 1.022, 95 % CI 0.983-1.063, P = 0.270). We found SBP (pooled HR 1.008, 95 % CI 1.002-1.014, P = 0.012), but not DBP (pooled HR 1.023, 95 % CI 0.964-1.085, P = 0.451) to be significantly associated with all-cause mortality.

CONCLUSIONS:

Current data confirms that PP is an independent risk factor for stroke but is not a predictor of mortality.

KEYWORDS:

Predictor of mortality; Pulse pressure; Risk factor; Stroke

PMID:
26902972
DOI:
10.1007/s00392-016-0972-2
[Indexed for MEDLINE]

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