When your doctor takes your blood pressure, they record two measurements — systolic pressure (the “top” number) and diastolic pressure (the “bottom” number). Your systolic blood pressure is the maximum pressure that your heart applies when beating. Your diastolic blood pressure is a measurement of the pressure in your arteries between heartbeats.
Pulse pressure is the difference between your systolic blood pressure and diastolic blood pressure. For example, if your systolic blood pressure is measured as 110 mm Hg and your diastolic blood pressure is measured as 80 mm Hg, then your pulse pressure would be 30 mm Hg.
What are the normal ranges of pulse pressure? What does a high or low pulse pressure measurement mean? Read on to find out more.
The normal range of pulse pressure is between 40 and 60 mm Hg.
Pulse pressure tends to increase after the age of 50. This is due to the stiffening of arteries and blood vessels as you age.
Your pulse pressure is considered low when it’s less than 40 mm Hg. Low pulse pressure can also be referred to as “narrow” pulse pressure.
A low pulse pressure can indicate decreased cardiac output. It’s often observed in people with heart failure.
Your pulse pressure is considered high when it’s more than 60 mm Hg.
High pulse pressure is also referred to as “wide” pulse pressure. As people age, it’s common for their pulse pressure measurement to widen. This can be due to high blood pressure or atherosclerosis, fatty deposits that build up on your arteries. Additionally, iron deficiency anemia and hyperthyroidism can lead to an increase in pulse pressure.
Low pulse pressure
One study found that a low pulse pressure was independently predictive of cardiovascular death in people with mild to advanced heart failure. The same study also found that a low pulse pressure was associated with worsened clinical findings.
A second study of people with chronic heart failure found that a low pulse pressure was associated with an increase in mortality. Low pulse pressure also correlated with a significant increase in brain natriuretic peptide (BNP), a protein associated with heart failure when observed in high levels.
High pulse pressure
An analysis of three trials of older individuals with high blood pressure (hypertension) found that a high pulse pressure was predictive of cardiovascular complications and mortality. An increase of pulse pressure by 10 mm Hg was found to increase the risk of a cardiovascular event, stroke, or overall mortality by 10–20 percent.
Another study found that an increased pulse pressure was associated with increased mortality among those with severe kidney disease.
However, a retrospective study of people admitted to a hospital for sepsis found that pulse pressure greater than 70 mm Hg was actually associated with a decrease in mortality.
Despite the fact that the calculated pulse pressure value can in some cases be predictive of disease outcome or overall mortality, it’s important to not overlook the measurements of systolic and diastolic blood pressure. High blood pressure readings are still predictive of adverse cardiovascular events as well.
For example, consider two people with a pulse pressure measurement of 60 mm Hg. One person has a blood pressure measurement of 120/60 mmHg while the second person has a blood pressure measurement of 180/120 mm Hg. Despite having the same pulse pressure measurement, the second person is more at risk for an adverse event.
Treatment of high blood pressure, if present, can often lead to a reduction in pulse pressure. It’s worth noting that different medications can affect blood pressure and pulse pressure in different ways.
Nitrates have been shown to reduce both systolic blood pressure and pulse pressure while retaining diastolic blood pressure levels.
Additionally, one study found that dietary supplementation with folic acid led to reduced pulse pressure in men with a normal or slightly elevated systolic blood pressure. This study was performed in healthy younger men (ages 20–40) and not in older participants with increased pulse pressure due to age or hypertension.
Pulse pressure is calculated by subtracting your diastolic blood pressure measurement from your systolic blood pressure measurement.
It tends to increase as you age, and it can be predictive of cardiovascular events such as heart attack or stroke. It’s important to keep both your blood pressure and pulse pressure in the ranges indicated by your doctor.
Treating high blood pressure can often lead to a reduction in pulse pressure as well. If you’re concerned about your pulse pressure value, talk to your doctor about steps you can take to reduce it.