Does the pulse pressure in people of European, African and South Asian descent differ? A systematic review and meta-analysis of UK data.

The aim of this study was to assess whether the pulse pressures (PPs) in people of African and South Asian descent differ from those of the European-origin White (henceforth, White) in the UK. A systematic literature review was carried out using MEDLINE 1966-2006 and EMBASE 1980-2006. The meta-analysis was performed using Cochrane review manager software (RevMan version 4.2; Oxford, UK). Thirteen studies were examined. Results for African descent men (n=9 studies) and women (n=7) indicated that African men and women had a higher mean PP than their White counterparts. Overall weighted mean difference (WMD) in PP was 1.68 (95% confidence interval: [0.38, 2.98 mm Hg]; P=0.01) in men and 2.01 ([0.39, 3.63 mm Hg]; P<0.001) in women. South Asian men (n=7 studies) had a lower mean PP than White men (-1.94; [-3.56, -0.32 mm Hg]; P=0.02), whereas no significant difference was found between South Asian and White women (n=5 studies) (-0.40; [-3.22, 2.39 mm Hg]; P=0.77). Separate data were available for Indians (n=5 studies), Bangladeshis (n=4) and Pakistanis (n=3). Bangladeshis had a lower PP than Whites (men, -5.61; [-6.87, -4.36 mm Hg]; P<0.001) (women, -5.21; [-8.67, -1.75 mm Hg]; P=0.003). Pakistani men had a lower PP than White men (-3.33 mm Hg; [-5.67, -1.00]; P<0.001). The WMD was nonsignificantly lower in Indian men (-0.76 mm Hg), Indian women (-0.80 mm Hg) and Pakistani women (-2.06 mm Hg). The higher PP found among African descent people may contribute to their more frequent hypertension complications. However, the lower PP in South Asian populations, particularly in Bangladeshis and Pakistani men, indicates that PP is unlikely to contribute to their higher risk of cardiovascular disease in the UK.