Table II.

Pathophysiology of Wide Pulse Pressure in the Elderly

↑ Large artery stiffness

↑ Early wave reflection, ↑ systolic blood pressure in late systole

↓ Coronary perfusion pressure

↑ Oxygen demand and subendocardial ischemia

↑ Ventricular‐vascular uncoupling

↑ Vascular afterload leading to ↑ left ventricular hypertrophy and ↑ left ventricular stiffness

↑ Late systolic wall load leading to ↓ left ventricular relaxation

↑ Defective mechanical signaling: ↓ nitric oxide production

↓ Cardiac reserve, diastolic dysfunction, congestive heart failure

↑ Flow turbulence, endothelial dysfunction, and atherosclerosis

↑ Pulsatile strain, plaque rupture, acute coronary syndrome

↑ =increased; ↓ =decreased