Table of ContentsView AllTable of ContentsCalculating Pulse PressureRangesNext Steps
Table of ContentsView All
View All
Table of Contents
Calculating Pulse Pressure
Ranges
Next Steps
Pulse pressure is a marker of stiffness within the body’s arteries. A high or wide pulse pressure signifies increased stiffness, which occurs naturally with age and diseases likeatherosclerosis(buildup of fatty deposits within artery walls).
Conversely, a low or narrow pulse pressure is seen withheart failure,aortic stenosis(a heart valve condition), and trauma associated with blood loss.
This article reviews the meaning behind a low (narrow), normal, and high (wide) pulse pressure and how to calculate it. It also explores the role of high pulse pressure as a predictor of cardiovascular risk in certain populations.
How to Calculate Your Pulse Pressure
Pulse pressure (PP) is calculated from a person’sblood pressure, which is the force, or measured impact, of blood on artery walls.
Blood pressure is measured in millimeters of mercury (mm Hg). A reading consists of two numbers, which are:
Pulse pressure is thesystolic blood pressure minus the diastolic blood pressure.
As an example, if a blood pressure reading is 110/70 mm Hg, the pulse pressure is 40 mm Hg (110 mm Hg minus 70 mm Hg). Likewise, if the blood pressure is 135/85 mm Hg, the pulse pressure is 50 mm Hg.
Systolic vs. Diastolic Blood Pressure
What Pulse Pressure Ranges Mean
Pulse pressure is a marker of artery stiffening, especially in elastic arteries near the heart, such as theaortaandcarotid arteries.
Arteries are blood vessels that carry nutrients and oxygen-rich blood away from the heart to vital organs.
Elastic arteries are large arteries that are uniquely flexible in structure. This allows them to withstand the high pressure and volume of blood from the heart to tissues throughout the body.
Normal Pulse Pressure
There is no formal definition for a “normal” pulse pressure. While most experts consider a pulse pressure of 40 mm Hg or less to be normal, some studies examining the effect of an elevated pulse pressure have used thresholds substantially higher, in the range of 50 to 60 mm Hg.
High or Wide Pulse Pressure
High pulse pressure reflects large artery stiffness and may occur as a result of the following:
The age-related widening of the pulse pressure reflects a change in the wall composition of large elastic arteries, including a decrease in elastin and an increase in collagen.
Atherosclerosiscan also lead to increased arterial stiffening. With this chronic condition,plaqueaccumulates within the arteries' walls. Plaque is comprised of fat, cholesterol, calcium, and a clotting substance called fibrin.
Athersclerotic DiseasesTwo prime examples of atherosclerotic diseases are:Coronary artery diseaseoccurs when plaque accumulates within the arteries that feed the heart.Carotid artery diseaseoccurs when plaque accumulates within the neck arteries that feed the brain.Aheart attackorstrokeoccurs when plaque blocks one or more arteries that supply oxygen-rich blood to the heart or brain.
Athersclerotic Diseases
Two prime examples of atherosclerotic diseases are:Coronary artery diseaseoccurs when plaque accumulates within the arteries that feed the heart.Carotid artery diseaseoccurs when plaque accumulates within the neck arteries that feed the brain.Aheart attackorstrokeoccurs when plaque blocks one or more arteries that supply oxygen-rich blood to the heart or brain.
Two prime examples of atherosclerotic diseases are:
Aheart attackorstrokeoccurs when plaque blocks one or more arteries that supply oxygen-rich blood to the heart or brain.
Other health conditions associated with high pulse pressure are:
Narrow or Low Pulse Pressure
A narrow or low pulse pressure is substantially lower than 40 mm Hg, although, as with elevated pulse pressures, no formal definition has been established. A narrow or low pulse pressure occurs with heart failure—when the heart muscle malfunctions and cannot pump enough blood to the body.
Other causes include:
After Pulse Pressure Reading: Next Steps
If your pulse pressure reading is high, speak with a healthcare provider.
A medical history and physical exam can assess overall health. Blood and urine tests may also be ordered to check for conditions linked to high pulse pressure, like hypertension or diabetes.
At present, measuring pulse pressure is most useful in adults over 60 years of age. In this population, an elevated pulse pressure greater than 55 mm Hg or 60 mm Hg is associated with an elevated cardiovascular risk (e.g., heart attacks and strokes).
Research has also found the same to be true for people with resistant hypertension.
What Is Resistant Hypertension?Resistant hypertension is a condition in which a person continues to have high blood pressure, even though they are taking at least three different medicines to lower it at maximum dose.
What Is Resistant Hypertension?
Resistant hypertension is a condition in which a person continues to have high blood pressure, even though they are taking at least three different medicines to lower it at maximum dose.
If you have high pulse pressure and are an older adult or have resistant hypertension, your healthcare provider might advise more aggressive monitoring.Further investigation is needed into whether lowering high pulse pressure can improve cardiovascularprognosis(outcome).
Treatment Plan
It’s unclear whether medications used to treat high blood pressure improve pulse pressure.
Until further research is done, high pulse pressure is not currently used to initiate or choose a particular high blood pressure medication.
Treating Low Pulse PressureTreatment of low or narrow pulse pressure entails managing the underlying condition.For example, blood transfusions are given to those with trauma-induced blood loss. Likewise, an invasive procedure to drain the fluid around the heart (called a pericardiocentesis) is performed for cardiac tamponade.
Treating Low Pulse Pressure
Treatment of low or narrow pulse pressure entails managing the underlying condition.For example, blood transfusions are given to those with trauma-induced blood loss. Likewise, an invasive procedure to drain the fluid around the heart (called a pericardiocentesis) is performed for cardiac tamponade.
Treatment of low or narrow pulse pressure entails managing the underlying condition.
For example, blood transfusions are given to those with trauma-induced blood loss. Likewise, an invasive procedure to drain the fluid around the heart (called a pericardiocentesis) is performed for cardiac tamponade.
Lifestyle and Self-Management
Lifestyle changes are an optimal method of preventing the development of conditions linked to high pulse pressure, such as hypertension and atherosclerotic disease.
These heart-healthy lifestyle behaviors include:
If you have already been diagnosed with underlying health conditions—such as high cholesterol, high blood pressure, or type 2 diabetes—follow your healthcare provider’s orders for that condition and take your medications as prescribed.
Also, depending on your medical history, your healthcare provider may suggest a specific diet—for example, theDASH diet(Dietary Approaches to Stop Hypertension) for hypertension.
Here’s How to Interpret Your Blood Pressure Chart
Summary
High pulse pressure (when the arteries are stiffer than they should be) occurs naturally with age. It’s associated with several health conditions, including high blood pressure (hypertension), the buildup of fatty substances within artery walls (atherosclerosis), type 2 diabetes, and chronic kidney disease.
Narrow pulse pressure is associated with heart failure, aortic stenosis (a heart valve disease), blood loss from trauma, and cardiac tamponade.
In older adults and individuals with resistant hypertension, high pulse pressure—mainly over 55 mm Hg or 60 mm Hg—serves as a potential risk factor or marker for cardiovascular events like heart attack and stroke.
Pulse pressure is used mainly as a research tool. However, as more research emerges, it may prove more valuable—perhaps helping healthcare providers guide treatment to minimize cardiovascular risk.
16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Melgarejo JD, Thijs L, Wei DM, et al.Relative and absolute risk to guide the management of pulse pressure, an age-related cardiovascular risk factor.Am J Hypertens. 2021;34(9):929-938. doi:10.1093/ajh/hpab048The Circulatory System. In: Mescher AL. eds.Junqueira’s Basic Histology Text and Atlas, 16e. McGraw Hill; 2021.Townsend RR.Increased pulse pressure. In:UpToDate, Bakris GL (Ed), UpToDate, Waltham, MAGavish B, Bursztyn M.Ambulatory pulse pressure components: concept, determination and clinical relevance.J Hypertens. 2019;37(4):765-774. doi:10.1097/HJH.0000000000001920Kim HL.Arterial stiffness and hypertension.Clin Hypertens. 2023;29(1):31. doi:10.1186/s40885-023-00258-1American Heart Association.Atherosclerosis.Selvaraj S, Steg PG, Elbez Y, et al.Pulse pressure and risk for cardiovascular events in patients with atherothrombosis: from the REACH Registry.J Am Coll Cardiol. 2016;67(4):392-403. doi:10.1016/j.jacc.2015.10.084Maeda T, Yokota S, Nishi T, et al.Association between pulse pressure and progression of chronic kidney disease.Sci Rep. 2021;11(1):23275. doi:10.1038/s41598-021-02809-8Yoon H, Lee JH, Kim GS, et al.The relationship between anemia and pulse pressure and hypertension: the Korea National Health and Nutrition Examination Survey 2010-2012.Clin Exp Hypertens. 2018;40(7):650-655. doi:10.1080/10641963.2017.1416123Go MT, George AM, Tahsin B, Fogelfeld L.Tachycardia in hyperthyroidism: not so common.PLoS One. 2022;17(9):e0273724. doi:10.1371/journal.pone.0273724D’Elia L, Barbato A, Iacone R, Russo O, Strazzullo P, Galletti F.Metabolic syndrome and its components predict the development of arterial stiffening in a sample of adult men.Clin Exp Hypertens. 2022;44(1):26-33. doi:10.1080/10641963.2021.1969664Tang KS, Medeiros ED, Shah AD.Wide pulse pressure: a clinical review.J Clin Hypertens (Greenwich). 2020;22(11):1960-1967. doi:10.1111/jch.14051Wells CL, Townsend M.Management of the acutely ill and medically complex older patient.In Guccione’s Geriatric Physical Therapy (pp. 309–343). 2019. St. Louis, Missouri: Elsevier. doi:10.1016/B978-0-323-60912-8.00014-2Bankhead-Kendall B, Teixeira P, Roward S, et al.Narrow pulse pressure is independently associated with massive transfusion and emergent surgery in hemodynamically stable trauma patients.Am J Surg. 2020;220(5):1319-1322. doi:10.1016/j.amjsurg.2020.06.042Moyá-Amengual A, Ruiz-García A, Pallarés-Carratalá V, et al.Elevated pulse pressure and cardiovascular risk associated in Spanish population attended in primary care: IBERICAN study.Front Cardiovasc Med. 2023;10:1090458. doi:10.3389/fcvm.2023.1090458Mesquita Bastos J, Ferraz L, Pereira FG, Lopes S.Systolic blood pressure and pulse pressure are predictors of future cardiovascular events in patients with true resistant hypertension.Diagnostics (Basel). 2023;13(10):1817. doi:10.3390/diagnostics13101817
16 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.Melgarejo JD, Thijs L, Wei DM, et al.Relative and absolute risk to guide the management of pulse pressure, an age-related cardiovascular risk factor.Am J Hypertens. 2021;34(9):929-938. doi:10.1093/ajh/hpab048The Circulatory System. In: Mescher AL. eds.Junqueira’s Basic Histology Text and Atlas, 16e. McGraw Hill; 2021.Townsend RR.Increased pulse pressure. In:UpToDate, Bakris GL (Ed), UpToDate, Waltham, MAGavish B, Bursztyn M.Ambulatory pulse pressure components: concept, determination and clinical relevance.J Hypertens. 2019;37(4):765-774. doi:10.1097/HJH.0000000000001920Kim HL.Arterial stiffness and hypertension.Clin Hypertens. 2023;29(1):31. doi:10.1186/s40885-023-00258-1American Heart Association.Atherosclerosis.Selvaraj S, Steg PG, Elbez Y, et al.Pulse pressure and risk for cardiovascular events in patients with atherothrombosis: from the REACH Registry.J Am Coll Cardiol. 2016;67(4):392-403. doi:10.1016/j.jacc.2015.10.084Maeda T, Yokota S, Nishi T, et al.Association between pulse pressure and progression of chronic kidney disease.Sci Rep. 2021;11(1):23275. doi:10.1038/s41598-021-02809-8Yoon H, Lee JH, Kim GS, et al.The relationship between anemia and pulse pressure and hypertension: the Korea National Health and Nutrition Examination Survey 2010-2012.Clin Exp Hypertens. 2018;40(7):650-655. doi:10.1080/10641963.2017.1416123Go MT, George AM, Tahsin B, Fogelfeld L.Tachycardia in hyperthyroidism: not so common.PLoS One. 2022;17(9):e0273724. doi:10.1371/journal.pone.0273724D’Elia L, Barbato A, Iacone R, Russo O, Strazzullo P, Galletti F.Metabolic syndrome and its components predict the development of arterial stiffening in a sample of adult men.Clin Exp Hypertens. 2022;44(1):26-33. doi:10.1080/10641963.2021.1969664Tang KS, Medeiros ED, Shah AD.Wide pulse pressure: a clinical review.J Clin Hypertens (Greenwich). 2020;22(11):1960-1967. doi:10.1111/jch.14051Wells CL, Townsend M.Management of the acutely ill and medically complex older patient.In Guccione’s Geriatric Physical Therapy (pp. 309–343). 2019. St. Louis, Missouri: Elsevier. doi:10.1016/B978-0-323-60912-8.00014-2Bankhead-Kendall B, Teixeira P, Roward S, et al.Narrow pulse pressure is independently associated with massive transfusion and emergent surgery in hemodynamically stable trauma patients.Am J Surg. 2020;220(5):1319-1322. doi:10.1016/j.amjsurg.2020.06.042Moyá-Amengual A, Ruiz-García A, Pallarés-Carratalá V, et al.Elevated pulse pressure and cardiovascular risk associated in Spanish population attended in primary care: IBERICAN study.Front Cardiovasc Med. 2023;10:1090458. doi:10.3389/fcvm.2023.1090458Mesquita Bastos J, Ferraz L, Pereira FG, Lopes S.Systolic blood pressure and pulse pressure are predictors of future cardiovascular events in patients with true resistant hypertension.Diagnostics (Basel). 2023;13(10):1817. doi:10.3390/diagnostics13101817
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Melgarejo JD, Thijs L, Wei DM, et al.Relative and absolute risk to guide the management of pulse pressure, an age-related cardiovascular risk factor.Am J Hypertens. 2021;34(9):929-938. doi:10.1093/ajh/hpab048The Circulatory System. In: Mescher AL. eds.Junqueira’s Basic Histology Text and Atlas, 16e. McGraw Hill; 2021.Townsend RR.Increased pulse pressure. In:UpToDate, Bakris GL (Ed), UpToDate, Waltham, MAGavish B, Bursztyn M.Ambulatory pulse pressure components: concept, determination and clinical relevance.J Hypertens. 2019;37(4):765-774. doi:10.1097/HJH.0000000000001920Kim HL.Arterial stiffness and hypertension.Clin Hypertens. 2023;29(1):31. doi:10.1186/s40885-023-00258-1American Heart Association.Atherosclerosis.Selvaraj S, Steg PG, Elbez Y, et al.Pulse pressure and risk for cardiovascular events in patients with atherothrombosis: from the REACH Registry.J Am Coll Cardiol. 2016;67(4):392-403. doi:10.1016/j.jacc.2015.10.084Maeda T, Yokota S, Nishi T, et al.Association between pulse pressure and progression of chronic kidney disease.Sci Rep. 2021;11(1):23275. doi:10.1038/s41598-021-02809-8Yoon H, Lee JH, Kim GS, et al.The relationship between anemia and pulse pressure and hypertension: the Korea National Health and Nutrition Examination Survey 2010-2012.Clin Exp Hypertens. 2018;40(7):650-655. doi:10.1080/10641963.2017.1416123Go MT, George AM, Tahsin B, Fogelfeld L.Tachycardia in hyperthyroidism: not so common.PLoS One. 2022;17(9):e0273724. doi:10.1371/journal.pone.0273724D’Elia L, Barbato A, Iacone R, Russo O, Strazzullo P, Galletti F.Metabolic syndrome and its components predict the development of arterial stiffening in a sample of adult men.Clin Exp Hypertens. 2022;44(1):26-33. doi:10.1080/10641963.2021.1969664Tang KS, Medeiros ED, Shah AD.Wide pulse pressure: a clinical review.J Clin Hypertens (Greenwich). 2020;22(11):1960-1967. doi:10.1111/jch.14051Wells CL, Townsend M.Management of the acutely ill and medically complex older patient.In Guccione’s Geriatric Physical Therapy (pp. 309–343). 2019. St. Louis, Missouri: Elsevier. doi:10.1016/B978-0-323-60912-8.00014-2Bankhead-Kendall B, Teixeira P, Roward S, et al.Narrow pulse pressure is independently associated with massive transfusion and emergent surgery in hemodynamically stable trauma patients.Am J Surg. 2020;220(5):1319-1322. doi:10.1016/j.amjsurg.2020.06.042Moyá-Amengual A, Ruiz-García A, Pallarés-Carratalá V, et al.Elevated pulse pressure and cardiovascular risk associated in Spanish population attended in primary care: IBERICAN study.Front Cardiovasc Med. 2023;10:1090458. doi:10.3389/fcvm.2023.1090458Mesquita Bastos J, Ferraz L, Pereira FG, Lopes S.Systolic blood pressure and pulse pressure are predictors of future cardiovascular events in patients with true resistant hypertension.Diagnostics (Basel). 2023;13(10):1817. doi:10.3390/diagnostics13101817
Melgarejo JD, Thijs L, Wei DM, et al.Relative and absolute risk to guide the management of pulse pressure, an age-related cardiovascular risk factor.Am J Hypertens. 2021;34(9):929-938. doi:10.1093/ajh/hpab048
The Circulatory System. In: Mescher AL. eds.Junqueira’s Basic Histology Text and Atlas, 16e. McGraw Hill; 2021.
Townsend RR.Increased pulse pressure. In:UpToDate, Bakris GL (Ed), UpToDate, Waltham, MA
Gavish B, Bursztyn M.Ambulatory pulse pressure components: concept, determination and clinical relevance.J Hypertens. 2019;37(4):765-774. doi:10.1097/HJH.0000000000001920
Kim HL.Arterial stiffness and hypertension.Clin Hypertens. 2023;29(1):31. doi:10.1186/s40885-023-00258-1
American Heart Association.Atherosclerosis.
Selvaraj S, Steg PG, Elbez Y, et al.Pulse pressure and risk for cardiovascular events in patients with atherothrombosis: from the REACH Registry.J Am Coll Cardiol. 2016;67(4):392-403. doi:10.1016/j.jacc.2015.10.084
Maeda T, Yokota S, Nishi T, et al.Association between pulse pressure and progression of chronic kidney disease.Sci Rep. 2021;11(1):23275. doi:10.1038/s41598-021-02809-8
Yoon H, Lee JH, Kim GS, et al.The relationship between anemia and pulse pressure and hypertension: the Korea National Health and Nutrition Examination Survey 2010-2012.Clin Exp Hypertens. 2018;40(7):650-655. doi:10.1080/10641963.2017.1416123
Go MT, George AM, Tahsin B, Fogelfeld L.Tachycardia in hyperthyroidism: not so common.PLoS One. 2022;17(9):e0273724. doi:10.1371/journal.pone.0273724
D’Elia L, Barbato A, Iacone R, Russo O, Strazzullo P, Galletti F.Metabolic syndrome and its components predict the development of arterial stiffening in a sample of adult men.Clin Exp Hypertens. 2022;44(1):26-33. doi:10.1080/10641963.2021.1969664
Tang KS, Medeiros ED, Shah AD.Wide pulse pressure: a clinical review.J Clin Hypertens (Greenwich). 2020;22(11):1960-1967. doi:10.1111/jch.14051
Wells CL, Townsend M.Management of the acutely ill and medically complex older patient.In Guccione’s Geriatric Physical Therapy (pp. 309–343). 2019. St. Louis, Missouri: Elsevier. doi:10.1016/B978-0-323-60912-8.00014-2
Bankhead-Kendall B, Teixeira P, Roward S, et al.Narrow pulse pressure is independently associated with massive transfusion and emergent surgery in hemodynamically stable trauma patients.Am J Surg. 2020;220(5):1319-1322. doi:10.1016/j.amjsurg.2020.06.042
Moyá-Amengual A, Ruiz-García A, Pallarés-Carratalá V, et al.Elevated pulse pressure and cardiovascular risk associated in Spanish population attended in primary care: IBERICAN study.Front Cardiovasc Med. 2023;10:1090458. doi:10.3389/fcvm.2023.1090458
Mesquita Bastos J, Ferraz L, Pereira FG, Lopes S.Systolic blood pressure and pulse pressure are predictors of future cardiovascular events in patients with true resistant hypertension.Diagnostics (Basel). 2023;13(10):1817. doi:10.3390/diagnostics13101817
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