When your doctor takes your blood pressure, they record two measurements:

  • systolic pressure (the “top” number)
  • 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 and diastolic blood pressure. For example, if your systolic blood pressure is 120 mm Hg and your diastolic blood pressure is 80 millimeters of mercury (mm Hg), your pulse pressure would be 40 mm Hg.

Why does pulse pressure matter?

Measuring your pulse pressure can help you monitor your risk of heart-related issues. A high measurement increases your risk of heart disease. High pulse pressure is often associated with an increased risk of heart attack or stroke, particularly in people assigned male at birth.

A pulse pressure increase of as little as 10 mm Hg can boost heart disease risk by up to 20 percent.

LowNormalHigh
<40 mm Hg 40–60 mm Hg>60 mm Hg

A normal pulse pressure range is between 40 and 60 mm Hg.

A pulse pressure reading is considered low when it’s less than 40 mm Hg. Low pulse pressure can indicate decreased cardiac output. It’s often observed in people with heart failure.

A pulse pressure reading is considered high when it’s more than 60 mm Hg. As people age, it’s common for their pulse pressure measurement to increase. 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.

It’s normal for these measurements to fluctuate, even when they’re taken back-to-back. Normal day-to-day activities can affect the readings, like:

  • physical activity
  • eating or drinking
  • talking or laughing

To get an accurate picture, take your blood pressure at the same time every day. Capture at least two readings up to 2 minutes apart. Keep a log of your readings and share it with your doctor to help determine if there’s an issue.

What does a narrow pulse pressure mean?

Low pulse pressure can also be referred to as “narrow” pulse pressure. This is in reference to the narrowing range between your systolic and diastolic blood pressure measurements.

What does a wide pulse pressure mean?

High pulse pressure is also referred to as “wide” pulse pressure. This is in reference to the widening range between your systolic and diastolic blood pressure measurements.

A 2018 study found that pulse pressure is a large predictor of new‐onset heart disease and related mortality. Another study found that a wide pulse pressure can also lead to organ damage and further increase cardiovascular risk, particularly as you age.

One 2021 study aimed to address how to manage pulse pressure-related health risks over time. Results found that practicing healthy lifestyle habits earlier in life can help reduce the risk of major pulse pressure-related cardiovascular events and mortality. This may also help extend lifespan and promote overall quality of life.

Pulse pressure measurements can predict an increase in heart disease risk, outcomes, or overall mortality. But systolic and diastolic blood pressure readings are also important. High blood pressure measurements can also increase the risk of heart disease and related cardiovascular events.

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 of 180/120 mm Hg. Despite having the same pulse pressure measurement, the second person is more at risk for an adverse event.

If needed, high blood pressure treatment can often reduce pulse pressure. Though 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 older study found that dietary supplementation with folic acid reduced pulse pressure in men with a normal or slightly elevated systolic blood pressure. This study was performed in younger men (ages 20–40) with no additional health concerns and not in older participants with increased pulse pressure due to age or hypertension.

How to manage my pulse pressure

If you’re looking to control pulse pressure, you can try some of the same lifestyle guidelines recommended for lowering high blood pressure. That includes:

  • eating a low-sodium, heart-healthy diet
  • staying active
  • limiting alcohol intake
  • quitting smoking
  • managing stress

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 like a 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. If you’re concerned about your pulse pressure value, talk with your doctor about steps you can take to reduce it.