Pulse pressure is the difference between your systolic blood pressure, which is the top number of your blood pressure reading, and diastolic blood pressure, which is the bottom number.

Doctors can use pulse pressure as an indicator of how well your heart is working. A high pulse pressure is sometimes called a wide pulse pressure. This is because there’s a large or wide difference between the systolic and diastolic pressure.

A low pulse pressure is a small difference between your systolic and diastolic pressure. In some cases, a low pulse pressure can also be a sign of a poorly functioning heart.

Most people have a pulse pressure between 40 and 60 mm Hg. Generally, anything above this is considered a wide pulse pressure.

Read on for more information about what your pulse pressure could tell you about your heart health.

To measure your pulse pressure, your doctor will start by measuring your blood pressure. They’ll likely use either an automatic blood pressure cuff or a device called a sphygmomanometer. Once they have your systolic and diastolic readings, they’ll subtract your diastolic pressure from your systolic pressure. This resulting number is your pulse pressure.

Wide pulse pressure can indicate a change in your heart’s structure or function. This may be due to:

  • Valve regurgitation. In this, blood flows backward through your heart’s valves. This reduces the amount of blood pumping through your heart, making your heart work harder to pump enough blood.
  • Aortic stiffening. The aorta is the major artery that distributes oxygenated blood throughout your body. Damage to your aorta, often due to high blood pressure or fatty deposits, can cause wide pulse pressure.
  • Severe iron deficiency anemia. In this condition, there aren’t enough hemoglobin cells in your blood due to lack of iron.
  • Hyperthyroidism. Your thyroid produces too much of a hormone called thyroxine, which affects many of your body’s processes, including the beating of your heart.

Having a wide pulse pressure also increases your risk of developing a condition called atrial fibrillation. This occurs when the top portion your heart, called the atria, quivers instead of beating strongly. According to Harvard Health, someone with a wide pulse pressure is 23 percent likely to have atrial fibrillation. This is compared with 6 percent for those whose pulse pressures are under 40 mm Hg.

A wide pulse pressure may also be associated with coronary artery disease or heart attack.

On its own, a wide pulse pressure usually doesn’t cause any symptoms. Over time, however, you might begin to notice:

  • ankle or foot swelling
  • difficulty breathing
  • dizziness
  • facial flushing
  • fainting
  • headaches
  • heart palpitations
  • weakness

Your symptoms will depend on the underlying cause of your wide pulse pressure.

A wide pulse pressure is usually a sign of an underlying problem, so treatments usually depend on the condition. However, most treatments involve lowering blood pressure, which can also lower a wide pulse pressure. While you can often do this by making some lifestyle or dietary changes, your doctor might prescribe medication for more severe cases.

Lifestyle changes

There are several steps you can take to manage your blood pressure.

  • Lose weight. If you are overweight, losing even 10 pounds can help reduce blood pressure.
  • Exercise. Try to get at least 30 minutes of exercise more days of the week than not. This can be as simple as taking a walk through your neighborhood.
  • Stop smoking. Smoking can harden your arteries, increasing pulse pressure. If you smoke, quitting can also make it easier to exercise as your lungs start to regain their full function.
  • Reduce your daily sodium intake. Aim to eat fewer than 1,500 to 2,000 milligrams of sodium per day.
  • Avoid drinking too much alcohol. Limit yourself to no more than two drinks per day for men and one drink per day for women.
  • Take steps to reduce stress. Stress can release inflammatory compounds in your body that contribute to increased blood pressure. Try a relaxing activity, such as mediating or reading, to help manage your stress.

Medications

Sometimes, diet and lifestyle changes aren’t enough to control high blood pressure. In these cases, your doctor may prescribe medication. There are several types of medication for managing high blood pressure, including:

Keep in mind that you may need additional treatment, including different medications, to get a wide pulse pressure under control, depending on the underlying cause.

Wide pulse pressure is usually an indication that something is causing your heart to work less efficiently. If you take your blood pressure regularly and calculate that your pulse pressure is wider than usual, it’s best to follow up with your doctor to figure out what’s causing it.