European Heart Journal Advance Access originally published online on September 1, 2005
European Heart Journal 2005 26(20):2120-2126; doi:10.1093/eurheartj/ehi467
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Importance of arterial pulse pressure as a predictor of coronary heart disease risk in PROCAM
1Institute of Arteriosclerosis Research at the University of Münster, Münster, Germany
2Bayer Vital GmbH, Leverkusen, Germany
Received 15 November 2004; revised 6 July 2005; accepted 28 July 2005; online publish-ahead-of-print 1 September 2005.
* Corresponding author: Institute of Clinical Chemistry and Laboratory Medicine, University of Münster, Albert-Schweitzer-Straße 33, 48149 Münster, Germany. Tel: +49 2 51 8 34 72 22; fax: +49 2 51 8 34 72 29. E-mail address: assmann{at}uni-muenster.de
See page 2081 for the editorial comment on this article (doi:10.1093/eurheartj/ehi427)
Aims To investigate pulse pressure (PP) as an independent predictor of coronary heart disease (CHD) risk.
Methods and results On the basis of a 10-year follow-up of 5389 men aged 35–65 at recruitment into PROCAM, we used a proportional hazards model to calculate the effect of systolic blood pressure (SBP), diastolic blood pressure (DBP), and PP on CHD risk after correcting for age, high-density lipoprotein cholesterol, LDL cholesterol, triglycerides, smoking, diabetes, and family history of premature CHD. Increases of 10 mmHg in DBP, SBP, and PP were associated with an increased CHD hazard ratio (HR) of 
10%. When the group was divided into the age groups <50, 50–59, and >59 years, this relationship was seen in the age group 50–59 years for DBP, SBP, and PP and in men aged 
60 for PP only (25% increase in HR). Overall, CHD risk in men with PP 70 mmHg was more three times that of men with PP <50 mmHg. This increased risk was not apparent at age <50 years, was greatest at age >60 years, and was also present in men who were normotensive at recruitment (SBP 
160 mmHg, DBP 95 mmHg).
Conclusion In older European men, increased PP is an important independent determinant of coronary risk, even among those initially considered normotensive.
Key Words: Pulse pressure • Blood pressure • Atherosclerosis • Myocardial infarction • Coronary risk
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