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Age‐Dependent Associations Between Pulse Pressure and Long‐Term Outcomes After Myocardial Infarction

Congliang Miao,Dandan Zhao,Shuohua Chen,Lina Xu,Yusong Huang,Huimin Li,Huibiao Deng,Lili Wu,Yuchen Wang,Yu Fu,Guoyan Wu,Shouling Wu,Jiang Hong,Wen-Yi Yang

Published 2025 in The Journal of Clinical Hypertension

ABSTRACT

Pulse pressure (PP) is a recognized marker of cardiovascular risk in the general population. However, its role as an independent predictor of recurrent cardiovascular events following myocardial infarction (MI) and whether there are age‐dependent differences in this relationship remains uncertain. We analyzed data from 4091 participants with a history of MI were enrolled in the Kailuan Study. Univariate and multivariable Cox models were used to analyze the associations between PP and primary outcome (composite cardiovascular events, a composite of all‐cause death, nonfatal recurrent MI, nonfatal hospitalization for heart failure or nonfatal stroke) and secondary outcomes (each individual components of composite endpoint) after MI. Over a median follow‐up of 7.8 years, 1610 composite cardiovascular events occurred. The mean baseline PP was 54.2 ± 16.1 mmHg. Compared with individuals in the first PP quartile, those in the fourth quartile had significantly greater risks of composite cardiovascular events (adjusted HR: 1.20; 95% CI: 1.03–1.41; p = 0.02) and recurrent MI (adjusted HR: 1.56; 95% CI: 1.03–2.36; p = 0.04). A linear, dose–response relationship was observed between PP and the risk of adverse cardiovascular outcomes (all p ≤ 0.02), except for stroke (p = 0.36). Subgroup analyses indicated that the association between PP and adverse outcomes was stronger among participants aged <60 years compared with older individuals. Elevated PP is an independent predictor of recurrent cardiovascular outcomes in post‐MI patients, with particularly stronger associations observed in younger and middle‐aged adults.

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