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The relationship between blood pressure (BP) and cardiovascular disease (CVD) has been extensively documented. However the benefit of anti-hypertensive drugs is less pronounced for coronary prevention than for stroke prevention. Because coronary and cerebral circulation obey different regulatory mechanisms we questioned the role of BP level per se (estimated by mean BP (MBP)) and aortic stiffness (estimated by aortic atherosclerosis and pulse pressre (PP)) on 2 different outcomes: acute myocardial infarction (MI) and acute stroke. The analysis was also repeated for 2 more liberal outcomes: coronary heart disease and cerebrovascular disease.

Orthostatic blood pressure (BP) variations have been related with cardiovascular events in hypertensive patients; they are associated with autonomic and neurohormonal abnormalities. Large vessels damages, i.e. aortic atherosclerosis (ATS), may exaggerate this BP deregulation and thus, amplify its prognostic consequence. This study aimed at investigating the interaction of ATS on the prognostic value of postural BP changes.