Perit Dial Int. 2009;29:163-170

Elevated pulse pressure is associated with an increased risk of all-cause and cardiovascular death in patients on peritoneal dialysis (PD), according to a Canadian study.

“Recognition of this characteristic as an important predictor of mortality suggests that one goal of antihypertensive therapy in PD patients should be to decrease elevated pulse pressure,” the authors wrote.

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The investigators, led by Dimitrios G. Oreopoulos, MD, PhD, of the University of Toronto, studied 306 adults who started PD between January 1, 2000, and December 31, 2005, at the University Health Network in Toronto. Subjects had a mean pulse pressure of 56.8 mm Hg. Age and diabetes significantly predicted elevated pulse pressure.

Each increment of 1 mm Hg in pulse pressure was associated with a 2.7% increased risk of all-cause mortality and a 4.1% increased risk of cardiovascular death after adjusting for systolic BP and other clinical and demographic parameters.