Abstract
Objetivo
Verificar el significado clínico y el valor pronóstico de la presión de pulso en población general anciana.
Diseño
Estudio descriptivo transversal realizado entre junio y octubre de 2000, en el ámbito de atención primaria.
Participantes
De la población de edad 3 60 años (n = 8.026) de 16 cupos de seis centros de salud de Asturias se obtuvo una muestra aleatoria simple de 415 personas.
Mediciones principales
Se analizaron variables demográficas y factores de riesgo cardiovascular y se investigó la presencia de patología cardiovascular asociada. El análisis se realizó mediante la división en terciles de la presión de pulso.
Resultados
Se incluyó a 338 personas (18,5% de pérdidas), con una edad media de 73 ± 7 años; el 64% eran mujeres. Las medias de la presión arterial sistólica (PAS) y diastólica (PAD) fueron 140 ± 18 y 80 ± 8 mmHg, respectivamente. Los terciles de presión de pulso fueron: tercil 1, £ 51 mmHg; tercil 2, 52–65 mmHg, y tercil 3, 3 66 mmHg. En relación con el tercil 1, los del tercil 3 son más viejos (p < 0,001) y presentan cifras de PAS más elevadas (p < 0,001). El tercil 3 se asocia con mayor prevalencia de hipertensión arterial, hipertensión sistólica aislada y peor control de la hipertensión, así como con una mayor prevalencia de cardiopatía isquémica (p = 0,018) y de patología cardiovascular global (p = 0,005). Tras el análisis de regresión logística la presión de pulso persistió como variable independiente (p = 0,017).
Conclusiones
En población general anciana la presión de pulso es un marcador de riesgo cardiovascular independiente.
Palabras clave: Presión de pulso, Hipertensión, Riesgo cardiovascular, Anciano
Abstract
Objective
To verify the clinical significance and the prognostic value of taking the pulse in the general elderly population.
Design
Transversal descriptive study between June and October 2000 within primary care.
Participants
A simple randomised sample of 415 people was obtained from the population aged 60 or over (n=8,026) from sixteen lists of six health centres in Asturias.
Main measurements
Demographic variables and cardiovascular risk factors were analysed and the presence of associated cardiovascular pathology was investigated. The analysis divided blood pressure at the pulse into terciles.
Results
338 people (18.5% losses), with an average age of 73±7, 64% of whom were women, were included. The SP and DP means were 140±18 and 80±8 mm Hg, respectively. The pulse pressure terciles were: tercile 1, £51 mm Hg, tercile 2, 52–65 mm Hg and tercile 3, 366 mm Hg. Those in tercile 3 were older than those in tercile 1 (P<.001) and had higher SP figures (P<.001). Tercile 3 was linked to greater prevalence of Hypertension, isolated systolic hypertension and worse control of hypertension; and also to greater prevalence of ischaemic cardiopathy (P=.018) and of overall cardiovascular pathology (P=.005). After logistical regression analysis, pulse pressure persisted as an independent variable (P=.017).
Conclusions
Among the elderly as a whole, blood pressure at the pulse is an independent marker of cardiovascular risk.
Key words: Pulse pressure, Hypertension, Cardiovascular risk, Elderly
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