# Pulse Pressure Predictions: What Ranges Suggest About Your Health

Medically reviewed by Richard N. Fogoros, MDMedically reviewed by Richard N. Fogoros, MD

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 like atherosclerosis (buildup of fatty deposits within artery walls).

Conversely, a low or narrow pulse pressure is seen with heart 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's blood 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:

• The top number is the systolic blood pressure, which is the pressure in arteries while the heart beats.

• The bottom number is the diastolic blood pressure, which is the pressure in the arteries while the heart rests between beats.

Pulse pressure is the systolic 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.

Learn More: 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 the aorta and carotid 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:

• An increase in systolic blood pressure, which naturally occurs after age 40. Hypertension (high blood pressure) may also cause increased systolic blood pressure.

• A decrease in diastolic blood pressure, which naturally occurs after age 50. Low diastolic blood pressure can also occur as a result of taking blood pressure medications.

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.

Atherosclerosis can also lead to increased arterial stiffening. With this chronic condition, plaque accumulates within the arteries' walls. Plaque is comprised of fat, cholesterol, calcium, and a clotting substance called fibrin.

### Athersclerotic Diseases

Two prime examples of atherosclerotic diseases are:

A heart attack or stroke occurs 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:

• Aortic stenosis: Narrowing of the valve that joins the heart's main pumping chamber to the aorta

• Cardiac tamponade: Excessive fluids that surround and squeeze the heart muscle, preventing it from pumping effectively; can be a complication of pericarditis (inflammation of the sac around the heart)

• Trauma associated with a significant amount of blood loss

## 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.

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 cardiovascular prognosis (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 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.

### 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:

• Avoiding smoking, secondhand smoke, vaping, and using other tobacco products

• Aiming for 150 minutes of moderately intense exercise (e.g., brisk walking) or 75 minutes of vigorous exercise (e.g., running) weekly

• Limiting alcohol intake

• Maintaining a healthy weight

• Consuming a diet rich in fruits, vegetables, whole grains, beans, lentils, nuts, fish, and chicken.

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, the DASH diet (Dietary Approaches to Stop Hypertension) for hypertension.

## Summary

Pulse pressure is calculated by subtracting the diastolic blood pressure from the systolic blood pressure.

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.

Read the original article on Verywell Health.