Systolic blood pressure and pulse pressure: role of 24-h mean values and variability in the determination of organ damage

An increasing amount of data suggests that systolic blood pressure (SBP) an d pulse pressure (PP) may more closely relate to and thus favour the athero genic process than does diastolic blood pressure (DBP), The baseline data f rom the ongoing European Lacidipine Study on Atherosclerosis (ELSA) recentl y indicated that carotid artery atherosclerosis in normocholesterolaemic pa tients with mild or moderate essential hypertension is more closely related to SBP and more so PP than to DBP and lipid variables, Other new data poin t to the effects of hypertension on arterial compliance, as well as the eff ects of 24-h blood pressure variability on arterial compliance and distensi bility. When viewed in their entirety, these data present a compelling case for the closer monitoring of SBP and PP with respect to arterial complianc e, and the need for aggressive blood pressure treatment to control and perh aps reverse the underlying pathological changes in arterial structure and f unction in hypertensive patients. J Hypertens 17 (suppl 5):S55-S61 (C) 1999 Lippincott Williams & Wilkins.