People’s understanding of blood pressure has gone through three stages: in the first stage, it was believed that diastolic blood pressure was the main determinant of hypertension complications, thus the treatment of hypertension focused on the decrease of its diastolic blood pressure, and it was believed that the systolic blood pressure was also increasing with age; in the second stage, with the application of evidence-based medicine, it was found that systolic blood pressure was the main determinant of the occurrence of hypertension complications; in the third stage, it was found that pulse pressure was the main determinant of cardiovascular and cerebrovascular complications, and its interrelationship with cardiovascular and cerebrovascular complications is significantly stronger than that of systolic and diastolic blood pressure. Elevated pulse pressure is an independent risk factor for cardiovascular and cerebrovascular disease, and epidemiological studies have demonstrated that: systolic and diastolic blood pressure increase with age, however, after the age of 50-60 years the increase in diastolic blood pressure stops and begins to decrease with age; on the contrary, systolic blood pressure continues to increase with age, with the result that pulse pressure increases with age while the mean arterial pressure remains unchanged. Elevated pulse pressure and atherosclerosis have a mutually reinforcing effect; elevated pulse pressure decreases perfusion in peripheral tissues, which is continuous in normal tissues and becomes pulsatile at elevated pulse pressure, making peripheral tissues susceptible to ischemia and thrombosis. For the heart, increased pulse pressure increases the peripheral resistance encountered by the heart during contraction, thus increasing the afterload on the heart, causing myocardial hypertrophy, and simultaneously increasing myocardial oxygen consumption; at the same time, coronary artery perfusion mainly takes place during the diastolic phase of the ventricle, and increased pulse pressure decreases diastolic pressure, resulting in a decrease in coronary artery perfusion pressure, thus reducing myocardial perfusion. A foreign study summarized the results of 1924 cases of middle-aged and elderly people aged 50 to 79 years with a mean follow-up of 4.3 years. They were free of coronary heart disease at the beginning of the observation and were not taking antihypertensive drugs, and coronary heart disease occurred in 433 at the end of the follow-up. The analysis showed that the correlation between pulse pressure and coronary artery disease was significantly stronger than that between systolic and diastolic blood pressure. The author had compared the relationship between pulse pressure, systolic pressure and diastolic pressure with age in 1747 non-hypertensive health checkups, and the results showed that pulse pressure and systolic pressure increased with age, while diastolic pressure first tended to rise and began to decline after age 60 (the results are shown in the table below). Comparison of pulse pressure, systolic and diastolic blood pressure by age group (mmHg) Age group Number of cases Pulse pressure Systolic blood pressure Diastolic blood pressure