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Pulse pressure as an independent predictor of stroke: a systematic review and a meta-analysis

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Abstract

Background

Recent evidence suggests that pulse pressure (PP) is a strong cardiovascular diseases’ risk factor. We systematically evaluated all relevant studies to determine whether PP can be used as an independent predictor of stroke and mortality.

Methods and results

A meta-analysis was performed by searching the published literature using MEDLINE, Cochrane and Google Scholar databases up to December 15, 2015. We measured the effect size expressed by hazard ratio (HR) and 95 % confidence interval (95 % CI). Eleven publications were included in the analysis. Pooled results demonstrated that 10 mmHg increase in PP was associated with increased risk of stroke occurrence (pooled HR 1.046, 95 % CI 1.025–1.068, P < 0.001). Additionally, systolic blood pressure (SBP) (pooled HR 1.053, 95 % CI 1.033–1.073, P < 0.001) and diastolic blood pressure (DPB) (pooled HR 1.056, 95 % CI 1.038–1.074, P < 0.001) were found to be significant predictors for stroke. We did not find a significant association between PP and all-cause mortality (pooled HR 1.022, 95 % CI 0.983–1.063, P = 0.270). We found SBP (pooled HR 1.008, 95 % CI 1.002–1.014, P = 0.012), but not DBP (pooled HR 1.023, 95 % CI 0.964–1.085, P = 0.451) to be significantly associated with all-cause mortality.

Conclusions

Current data confirms that PP is an independent risk factor for stroke but is not a predictor of mortality.

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Acknowledgments

This work was financially supported by the National Natural Science Foundation of China (Nos. 81271302 and 81070914 to J. R. Liu), the ‘‘Science and Technology Project’’ of the Shanghai Pudong New Area Health Bureau (Pudong New Area Population and Family Planning Commission) (No. PW 2013D-4, to J. R. Liu), research innovation project from Shanghai municipal science and technology commission (No. 14JC1404300, to J. R. Liu), open fund of national key laboratory of medical and neurobiology of Fudan University (No. SKLMN2014001, to J. R. Liu), and project (2015) from SHSMU-ION Research Center for Brain Disorders (to J. R. Liu), and Clinical science and technology innovation project of Shanghai Shen Kang Hospital Development Center (No. SHDC12015310, to J. R. Liu).

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    Authors and Affiliations

    1. Department of Neurology, Jiuyuan Municipal Stroke Center, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University, School of Medicine, 639 Zhizaoju Road, Huangpu District, Shanghai, 200011, China

      Feng-Di Liu, Xiao-Lei Shen, Rong Zhao, Xiao-Xiao Tao, Shuo Wang, Bo Zheng, Qi-Ting Zhang, Qian Yao, Ying Zhao, Xin Zhang, Xue-Mei Wang, Liang Shu & Jian-Ren Liu

    2. Department of Neurology, Xixi Hospital of Hangzhou, Zhejiang University of Traditional Chinese Medicine, Hangzhou, 310023, China

      Jia-Jun Zhou

    3. Department of Neurology, Henan Provincial People’s Hospital, Zhengzhou, China

      Hui-Qin Liu

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    1. Feng-Di Liu
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    F.-D. Liu, X.-L. Shen and R. Zhao contributed equally to this work.

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    Liu, FD., Shen, XL., Zhao, R. et al. Pulse pressure as an independent predictor of stroke: a systematic review and a meta-analysis. Clin Res Cardiol 105, 677–686 (2016). https://doi.org/10.1007/s00392-016-0972-2

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