Comparison of Cardiovascular Risk Factors for High Brachial Pulse Pressure in Blacks Versus Whites (Charleston Heart Study, Evans County Study, NHANES I and II Studies)

We examined whether the risk factors for increased brachial pulse pressure (PP) are similar for blacks and whites. Many studies have reported the strong association of increased brachial PP and the prevalence of cardiovascular disease. Participants were from 4 major epidemiologic studies in the United States (26,083 subjects): Charleston Heart Study, Evans County Heart Study, the National Health and Nutrition Examination Survey (NHANES) I study, and the NHANES II study. At baseline, there was no history or clinical evidence of coronary heart disease (CHD). The CHD mortality as a function of brachial PP and the association of traditional risk factors for CHD with PP were analyzed for each of the 4 studies and for the 4 studies combined. Multiple regression analysis showed that the most significant predictors of high brachial PP are body mass index ≥30 kg/m2 (regression coefficient 3.79, p <0.0001), diabetes mellitus (5.14, p <0.0001), serum total cholesterol ≧240 mg/dl (0.51, p <0.0157), age (0.60, p <0.0001), gender (−1.77, p <0.0001), and race (3.75, p <0.0001). In conclusion, the same risk factors for CHD (namely, increase in body mass index ≧30 kg/m2, diabetes mellitus, hypercholesterolemia, and age) are significantly associated with high brachial PP for blacks and whites. These risk factors were stronger in whites compared with blacks. However, female gender and age variables were even more associated with brachial PP in blacks. Smoking was significant but not reflected in peripheral brachial PP as it is in aortic PP.