# Association between pulse pressure and carotid plaques in old adults with uncontrolled hypertension: results from a community-based screening in Hangzhou, China

## TL;DR

This study finds that higher pulse pressure is linked to more carotid plaques in older adults with uncontrolled high blood pressure, suggesting a risk for atherosclerosis.

## Contribution

The study identifies a strong independent association between elevated pulse pressure and carotid plaques in older adults with uncontrolled hypertension.

## Key findings

- Elevated pulse pressure is independently associated with carotid plaques in older adults with uncontrolled hypertension.
- Each 1-SD increase in pulse pressure raises the risk of carotid plaques by 40.1%.
- The association is stronger for multiple and soft plaques.

## Abstract

There is a broad pulse pressure (PP) and a high prevalence of carotid plaques in old adults. Previous studies have indicated that PP is strongly associated with carotid plaque formation. This study aimed to explore this association in old adults with uncontrolled hypertension.

1371 hypertensive patients aged ≥ 60 years with uncontrolled hypertension were enrolled in a community-based screening in Hangzhou, China. Carotid plaques were assessed using ultrasonography. Logistic regression models were used to estimate the association between PP and carotid plaques by odds ratios (ORs) and 95% confidence intervals (CIs).

Carotid plaques were detected in 639 (46.6%) of subjects. Multiple plaques were found in 408 (63.8%) and soft plaques in 218 (34.1%). Elevated PP was associated with a high prevalence of carotid plaques. After adjusting for traditional risk factors, compared to patients within the lowest tertile of PP, those within the highest tertiles had an increased risk of carotid plaques (OR 2.061, CI 1.547–2.745). For each 1-SD increase, the risk increased by 40.1% (OR 1.401, CI 1.237–1.587). There was a nonlinear association between PP and carotid plaques (P nonlinearity = 0.039). The risk increased rapidly after the predicted PP level reached around 60 mmHg. The associations were stronger among participants with multiple and soft plaques.

Our findings suggested that PP was independently associated with carotid plaques in old adults with uncontrolled hypertension who have an increased risk of atherosclerosis.

The online version contains supplementary material available at 10.1186/s12872-024-03914-y.