Pulse pressure naturally increases over time as individuals’ age due to arteriosclerosis and diffuse vascular stiffening. However, the differential for widened pulse pressure is broad and includes causes of hyperdynamic circulation and high‐output heart failure, such as aortic regurgitation and hyperthyroidism. In the absence of an underlying cause, wide pulse pressure is a sign of deteriorating cardiovascular health and carries increased risk for mortality, disease progression, and adverse clinical outcomes in chronic diseases including cardiovascular disease and chronic kidney disease. Current emphasis of antihypertensive treatment on systolic and diastolic blood pressure does not always address pulse pressure, thus subjecting many patients to an independent risk factor for poor outcomes. Pulse pressure control is more successfully achieved with thiazide diuretics and long‐acting nitrates when compared to other antihypertensive agents, but further research is needed to quantify the additional benefits of pulse pressure control over conventional blood pressure therapy. This case review provides an overview of the pathogenesis, pathologic causes, and treatment of widened pulse pressure and evaluates current evidence for pulse pressure as a predictor of clinical outcomes.

中文翻译：

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宽脉压：临床回顾

由于动脉硬化和弥漫性血管硬化，随着个人年龄的增长，脉压自然会随着时间的推移而增加。然而，脉压增宽的差异很大，包括高动力循环和高输出量心力衰竭的原因，如主动脉瓣关闭不全和甲状腺功能亢进。在没有根本原因的情况下，宽脉压是心血管健康恶化的标志，并且会增加心血管疾病和慢性肾病等慢性病的死亡率、疾病进展和不良临床结果的风险。目前对收缩压和舒张压的降压治疗的重点并不总是解决脉压，因此使许多患者受到不良结果的独立危险因素的影响。与其他抗高血压药物相比，噻嗪类利尿剂和长效硝酸盐可更成功地控制脉压，但需要进一步研究以量化脉压控制相对于常规血压治疗的额外益处。本病例综述概述了脉压增宽的发病机制、病理原因和治疗，并评估了脉压可作为临床结果预测因子的当前证据。