Pulse pressure is the difference between your systolic (upper) and diastolic (lower) blood pressure numbers. When you measure your blood pressure, your reading has two numbers:
- Systolic blood pressure: Pressure exerted by blood against the artery walls as the heart is beating.
- Diastolic pressure: Pressure exerted by blood against the artery walls as the heart is resting in between the beats.
To get your pulse pressure, you subtract the diastolic number from the systolic. For example, if your blood pressure is 120/80 mmHg, your pulse pressure is 40 (120 - 80 = 40).
Monitoring pulse pressure is important because it can help you identify your risk of developing heart problems before you develop symptoms.
What is normal pulse pressure?
A healthy pulse pressure range is between 40 and 60 mmHg.
Studies have shown that in some people, a 10 mmHg increase in pulse pressure elevates the risk of heart disease by 20%.
Other studies have shown that people with higher pulse pressure may develop atrial fibrillation at a higher rate when compared to those with lower pulse pressure.
What is high pulse pressure?
A high pulse pressure or wide pulse pressure is above 60 mmHg. While it’s common for pulse pressure to increase with advancing age, pulse pressure above 60 mmHg could be a warning sign for heart disease, heart attack, stroke and other serious conditions, especially in older adults.
As pulse pressure rises, risk of diabetes, chronic kidney disease (CKD), and other metabolic disorders goes up.
Medical conditions that may increase pulse pressure include:
- Severe iron deficiency anemia
- Arteriosclerosis (thickening and hardening of the artery walls)
- Hypertension
- Aortic regurgitation (a condition where the heart valve doesn’t close properly)
- Aortic sclerosis (thickening of aortic valve present in the heart)
- Hyperthyroidism
- Hypovolemia (low blood volume)
- Bradycardia (decreased heart rate)
- Irregular heartbeat
Apart from age and diseases, other factors that may lead to increased pulse pressure include:
- Intense exercise
- Having large muscle mass
- Genetics
- Slower heart rate
What is low pulse pressure?
A low pulse pressure or narrow pulse pressure is lower than 40 mmHg. Narrow pulse pressure may indicate that your heart isn’t pumping enough blood. Some other causes of low pulse pressure include:
- Heart failure
- Blood loss
- Aortic stenosis (narrowing of the aortic valve in the heart)
- Cardiac tamponade (compression of the heart caused by the accumulation of fluid in the sac surrounding the heart)
Is pulse pressure more important than blood pressure?
Studies suggest that pulse pressure may be more relevant in determining cardiovascular risk and type 2 diabetes than blood pressure.
However, monitoring systolic and diastolic blood pressure is still important, since high blood pressure is a significant indicator of heart disease.
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Homan TD, Bordes S, Cichowski E. Physiology, Pulse Pressure. [Updated 2021 Jul 15]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021. https://www.ncbi.nlm.nih.gov/books/NBK482408/
Buda VA, Ciobanu DM, Roman G. Pulse Pressure Is More Relevant Than Systolic and Diastolic Blood Pressure in Patients With Type 2 Diabetes and Cardiovascular Disease. Clujul Med. 2018;91(4):408-413. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6296723/
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REFERENCE: CDC. High Blood Pressure. Updated: Nov 13, 2017.
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