Abstract
The associations of blood pressure components with cardiovascular risks and death remain unclear, and the definition of wide pulse pressure (PP) is still controversial. Using data from 1257 participants without a history of cardiovascular disease, who were followed for 4.84 years, we performed multivariable Cox regression analyses to assess how systolic blood pressure (SBP), diastolic blood pressure (DBP), and PP contribute to risks of cardiovascular events and all-cause death. Among all participants, SBP and PP were significantly associated with the risks of cardiovascular events and all-cause death (all p < .05). DBP was not significantly associated with the risk of all-cause death; rather, it was only associated with a marginally significant 1% increased risk for cardiovascular events (p = 0.051). In participants aged < 65 years, DBP was significantly associated with a 3% increased risk for cardiovascular events (hazard ratio [HR]: 1.03, 95% confidence interval [95% CI]: 1.01-1.06). The association between PP and cardiovascular events appeared to be J-shaped in comparison to participants with the lowest-risk PP (50-60 mmHg), with adjusted HRs of 1.71 (95% CI: 1.03-2.85), 1.63 (95% CI: 1.00-2.68), and 2.13 (95% CI: 1.32-3.43) in the <50, 60.0-72.5, and ≥72.5 mmHg subgroups, respectively. The optimal cutoff points of a wide PP for predicting the risks of cardiovascular events and all-cause death were 70.25 and 76.25 mmHg, respectively. SBP and PP had a greater effect on cardiovascular risk, whereas DBP independently influenced cardiovascular events in middle-aged participants. Considerable PP alterations should be avoided in antihypertensive treatment.