Wu X, et al. Coron Artery Dis. 2019 Jun;30(4):297-302.
Wu X, et al., conducted a study to define the association between pulse pressure (PP) and coronary artery calcification (CAC), a proven surrogate marker for coronary heart disease. Almost, 170 participants, 50–70 years of age from 11 villages of Yunnan Province of China were recruited in the study. Routine examination was conducted for diastolic and systolic blood pressure, PP, and CAC. It was observed that PP values were positively associated with FRS 10-year CHD risk (r= 0.498, p < 0.0001) (Figure 1). The average PP and the average SBP, were statistically significantly different between the CAC-positive group and the CAC-negative group, but difference was not observed with the average DBP) (Figure 2). Adversely, mean CAC score differences were observed between PPHi and PPLow groups, similarly with the SBPHi group and the SBPLow group, but not between different DBP groups (Figure 3). Significant correlation was observed between the PP values and the CAC Agatston score, volume, mass, and in (density +1) (Figure 4). The values of AUC for was 0.785 highest in PP followed by 0.765 with CHD risk, 0.699 with age and 0.555 with SBP, relative to positive CAC (Figure 5).
Thus, among the rural people of southwest of China, PP is positively associated with the coronary calcium Agatston score, volume, mass, and density. PP predicted CAC as well as Framingham Risk. The measurement of PP widening may serve as a substitute and favourable method for estimating CAC risk in rural populations with poor accessibility and economic limitations over coronary computed tomography scanning.
Figure 1: PP correlated with 10-year CHD risk. CHD, coronary heart disease; FRS, Framingham Risk Score; PP, pulse pressure.
Figure 2: The aggregation pattern of blood pressure in different CAC status. *p< 0.05; ***p<0.0001. CAC, coronary artery calcification; DBP, diastolic blood pressure; PP, pulse pressure; SBP, systolic blood pressure.
Figure 3: The mean CAC scores in different blood pressure groups. **p< 0.001; ***p<0.0001. CAC, coronary artery calcification; DBP, diastolic blood pressure; PP, pulse pressure; SBP, systolic blood pressure.
Figure 4: Correlation analysis between PP and coronary artery calcification Agatston score (a), volume (b), mass (c), density (d) and in (density +1) (e).
Figure 5: Receiver operating characteristic curve and AUC showing the predicting power of age, systolic pressure, Framingham Risk Score 10-year coronary heart disease risk score, and PP in the prediction of coronary artery calcification. AUC, area under the curve; CI, confidence interval; PP, pulse pressure. (a) Methodology of DeLong et al. (1988). (b) Binomial exact 95% confidence intervals.
