Pulse Pressure: What the Gap in Your Reading Shows

Pulse pressure is the difference between the top (systolic) and bottom (diastolic) numbers in your blood pressure reading. For example, a person with a blood pressure of 120/80 mmHg has a pulse pressure of 40 mmHg (120 - 80). Your pulse pressure reflects the force your heart generates each time it contracts and provides insight into the health of your arteries. Pulse pressure tends to increase as we age, because the arteries become stiffer and less flexible.

High pulse pressure is a predictor of cardiovascular events, heart failure, and overall mortality. It can also be an indicator of medical conditions such as aortic regurgitation, hyperthyroidism, or high-output heart failure. Lifestyle interventions such as aerobic exercise and dietary modifications (e.g., increased intake of omega 3 fatty acids) can increase the compliance or ‘elasticity’ of the arteries, lowering pulse pressure and cardiovascular risk.

People who do a lot of aerobic exercise may have a low pulse pressure because their arteries are very compliant. Low pulse pressure may also be seen in people with heart failure, aortic stenosis, massive blood loss, postural orthostatic tachycardia syndrome (POTS), and hypothyroidism. This means that low pulse pressure on its own is not necessarily “good” or “bad”, and it is important for results to be interpreted together with your systolic and diastolic blood pressure and overall health history.

Based on reported relationships between pulse pressure and clinical outcomes, the following ranges are used: <50 mmHg (Optimal) and ≥50 mmHg (High, at risk).

Given that low pulse pressure in isolation is not predictive of poor health outcomes, no lower ‘at risk’ cutoff has been identified.