Editorial
Pulse pressure and prognosis
| The first 150 words of the full text of this article appear below. |
Many
epidemiological studies have demonstrated the
close relation between blood pressure and the subsequent
development of cardiovascular disease. Blood pressure has
characteristically been defined by its direct relation with cardiac
output and peripheral resistance. In essential hypertension, the most
consistent cause for an elevated blood pressure is an increase in
peripheral resistance, rather than cardiac output. This increase in
peripheral resistance, considered to be caused by arteriolar
constriction, was shown in early physiologic experiments to be best
represented by an increase in diastolic pressure.1
Consequently, it was generally believed that the hazard of hypertension
to the cardiovascular system was derived principally from the diastolic
component of blood pressure. This viewpoint was subsequently reinforced
by a number of therapeutic trials, showing the benefits of treating hypertension defined on the basis of elevated diastolic blood pressures. At the same time, systolic blood pressure was considered to
reflect elasticity of the large arteries
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