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To the Editor: Dr Domanski and colleagues¹ concluded that pulse pressure alone may not be as strong a predictor of cardiovascular disease-related mortality as SBP and DBP together.

The subjects in this study only included men aged 35 to 57 years, an age that may be too young to associate pulse pressure with cardiovascular events. Several previous studies have found that pulse pressure is a predictor of coronary events in patients aged 60 years or older.^2-4 Thus, the study of Domanski et al may not be a conclusive indicator of the risk of elevated pulse pressure in all age groups.

Travis S. Hiles, MA
University of Kansas School of Medicine

Patrick M. Moriarty, MD
Lipid, Atherosclerosis and Metabolic Clinic
University of Kansas Medical Center
Kansas City

1. Domanski M, Mitchell G, Pfeffer M, et al. Pulse pressure and cardiovascular disease–related mortality: follow-up study of the Multiple Risk Factor Intervention Trial (MRFIT). JAMA. 2002;287:2677-2683. FREE FULL TEXT 2. Benetos A, Safar M, Rudnichi A, et al. Pulse pressure: a predictor of long-term cardiovascular mortality in a French male population. Hypertension. 1997;30:1410-1415. FREE FULL TEXT 3. Franklin SS, Khan SA, Wong ND, Larson MG, Levy D. Is pulse pressure useful in predicting risk for coronary heart disease? the Framingham Heart Study. Circulation. 1999;100:354-360. FREE FULL TEXT 4. Glynn RJ, Chae CU, Guralnik JM, Taylor JO, Hennekens CH. Pulse pressure and mortality in older people. Arch Intern Med. 2000;160:2765-2772. FREE FULL TEXT

Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.

JAMA. 2003;289:174-175.

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