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Pulse pressure: An indicator of heart health?
By Mayo Clinic staffOriginal Article: http://www.mayoclinic.com/health/pulse-pressure/AN00968
- With Mayo Clinic emeritus hypertension specialist
Sheldon G. Sheps, M.D.
read biographyclose windowBiography of
Sheldon G. Sheps, M.D.
Sheldon Sheps, M.D.
Dr. Sheldon Sheps, emeritus professor of medicine and former chair of the Division of Nephrology and Hypertension in the Department of Medicine at Mayo Clinic, has been with Mayo Clinic since 1960.
Dr. Sheps, a Winnipeg, Manitoba, native, is board certified in internal medicine and specializes in hypertension and peripheral vascular diseases. He developed a multidisciplinary approach with specially trained nurses, dietitians, technicians and educators to help form a team approach to the treatment of patients with abnormal blood pressure.
"I have always believed in involving the patient and family in their health care," Dr. Sheps says. "I have asked for their understanding of the illness and issues and for participation in decisions. The Web is a natural extension of that, and now many more people can be informed."
Dr. Sheps chaired the sixth working group, and he participated in the fourth, fifth and seventh groups that developed the then-latest guidelines for hypertension under the auspices of the National Heart, Lung, and Blood Institute (NHLBI). He helped write the latest American Heart Association (AHA) report on blood pressure measurement. He chaired an AHA group that produced an online accreditation for blood pressure measurement for health professionals.
Dr. Sheps has co-authored books, newsletters, CD-ROMs and other Mayo Clinic health information material. He joined Mayo Clinic's Web team in 1998. He was medical editor-in-chief of both editions of the "Mayo Clinic on High Blood Pressure" book; the last edition was published in 2003. He was also medical editor-in-chief of "Mayo Clinic 5 Steps to Controlling High Blood Pressure," published in 2008.
In addition, Dr. Sheps was section editor for each of the first three editions of "Hypertension Primer" for the American Heart Association.
Dr. Sheps was also chairman of the Science Base Subcommittee and the National High Blood Pressure Education Program, and he was a consultant to the Hypertension Initiative of the World Health Organization. In 1997, he was honored with the Individual Achievement Award on the 25th anniversary of the National High Blood Pressure Education Program of NHLBI. In 2009, he was honored as a Distinguished Mayo Alumnus.
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Question
Pulse pressure: An indicator of heart health?
What is pulse pressure? How important is pulse pressure to your overall health?
Answer
from Sheldon G. Sheps, M.D.
Blood pressure readings are given in two numbers. The top number is the maximum pressure your heart exerts while beating (systolic pressure), and the bottom number is the amount of pressure in your arteries between beats (diastolic pressure). The numeric difference between your systolic and diastolic blood pressure is called your pulse pressure. For example, if your resting blood pressure is 120/80 millimeters of mercury (mm Hg), your pulse pressure is 40 — which is considered a normal and healthy pulse pressure.
A high pulse pressure may be a strong predictor of heart problems, especially for older adults. Generally, a pulse pressure greater than 40 mm Hg is abnormal. A pulse pressure lower than 40 may mean you have poor heart function, while a higher pulse pressure may mean your heart's valves are leaky (valve regurgitation).
The most important cause of elevated pulse pressure is stiffness of the aorta, the largest artery in the body. The stiffness may be due to high blood pressure or fatty deposits on the walls of the arteries (atherosclerosis). The greater your pulse pressure, the stiffer and more damaged the vessels are thought to be. Other conditions — including severe iron deficiency (anemia) and overactive thyroid (hyperthyroidism) — can increase pulse pressure as well.
Treating high blood pressure usually reduces pulse pressure as well.
Next questionBlood pressure: Does it have a daily pattern?
- Townsend RR. Increased pulse pressure. http://www.uptodate.com/home/index.html. Accessed Sept. 30, 2010.
- Benetos A, et al. Pulse pressure amplification: A mechanical biomarker of cardiovascular disease risk. Journal of the American College of Cardiology. 2010;55:1032.
- Roman MJ, et al. High central pulse pressure is independently associated with adverse cardiovascular outcome. Journal of the American College of Cardiology. 2009;54:1730.
- Avolio AP, et al. Role of pulse pressure amplification in arterial hypertension: Experts' opinion and review of the data. Hypertension. 2009;54:375.
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