Most of the individuals with hypertension, especially those above 60 years of age have predominantly elevated systolic pressure and wide pulse pressure. Elevated diastolic pressure and fairly normal pulse pressure is sometimes found in younger and middle aged individuals. The wide pulse pressure in elderly is a reflection of reduced vascular compliance consequent to vascular remodelling. The wide pulse pressure in a very young individual especially with testing tachycardia is due to an increase in cardiac output.

Most of the problems related to hypertension like stroke, coronary events, LVH, heart failure and renal impairment are more strongly related to systolic BP than diastolic BP. Wide pulse pressure probably is even more important and very strongly correlated with adverse events.

In conditions where the systolic BP is high with low diastolic BP and wide pulse pressure due to hyperdynamic circulatory state like AR or anaemia, it is unusual to find evidence of CAD and higher incidence of stroke.

Thanks for the contribution

We could collaborate for this work and publish an article indexed JCR between both working groups