Talk:Pulse pressure

Pulse Pressure of the systemic and pulmonary circulations, error?

The claim that pulse pressure is less in the systemic circulation than in the pulmonary circulation seems to me to be absolutely wrong. Let me describe this mathematically for ease of description:

Systemic Pulse P: P(sys) - P(dia)= 120 - 80 = 40mmHg

Pulmonary Pulse P: P(sys) - P(dia)= 25 - 10 = 15mmHg

How could anyone claim that 15mmHg is more than 40mmHg? Now maybe the gentleman meant that the proportional pulse pressure compared to total pressure was greater in the pulmonary circulation but I don't know. Someone tell me that I am wrong about this and my math is mistaken or I am going to change the post in a week or two...

Thank you Orlandoturner (talk) 02:07, 23 August 2009 (UTC)

This issue has been addressedMedGME (talk) 10:51, 18 December 2022 (UTC)

Confusing pulse pressure with systolic pressure and mean arterial pressure

This article seems to be confused with how to differentiate pulse pressure from systolic pressure and MAP.

I agree with the following definition from http://highbloodpressure.about.com/od/highbloodpressure101/p/pulse_pressure.htm

"Blood pressure measurements include both a systolic and a diastolic reading. These two readings are taken at opposite ends of the cardiac cycle and are a person's highest and lowest blood pressure levels. The difference between these two extremes is called the pulse pressure, and represents the force that your heart generates each time it contracts."

See http://www.google.com/search?q=narrowing%20widening%20pulse%20pressure

Trevor Wennblom (talk) 04:27, 25 January 2009 (UTC)

Dr

Dr.Asmaa,adoctor resident in Assuit university hospital searching in pulse pressure and its relation to CVD

How to lower PULSE PRESSURE??? (signed: interested 59 yr. old)

Folic acid? [1]

Link found in a searcj and posted without comment. Pol098 17:56, 22 March 2006 (UTC)

The actual definition of pulse pressure is NOT the difference between the systolic value and diastolic value as normally perceived and is in fact the total pressure throughout a single cardiac cycle divided by the time it takes for one cycle to complete — Preceding unsigned comment added by Dr. Giver (talk • contribs) 21:31, 31 March 2011 (UTC)

References

@Dr. Giver: I think you may be confusing pulse pressure with Mean arterial pressure, which is a related, but distinct concept. Vontheri (talk) 23:06, 22 June 2023 (UTC)

Pulse pressure and antihypertensives

Am very interested in this, as it is not something I have come accross before. However, I can't persue it any further because the comment is not referenced... argh! Does anybody know of a reference for it?--John24601 21:16, 14 September 2006 (UTC)

Confusion between terms: genuinely low vs very low

I found the following fragment somewhat confusing:

If the usual resting pulse pressure is measured as less than 40 mm Hg, the most common reason is an error of measurement. If the pulse pressure is genuinely low, e.g. 25 mm Hg or less, ....

I would have thought that if there is no measurement error, then any value of less than 40 mm Hg is “genuinely low”, while a value of 25 mm Hg should perhaps be described as “very low”. Rahul (talk) —Preceding comment was added at 11:06, 31 May 2008 (UTC)

Inconsistency:

"Theoretically, the systemic pulse pressure can be conceptualized as being proportional to stroke volume and inversely proportional to the compliance of the aorta[1]. For instance, even though the right and left ventricles have similar stroke volumes, because the aorta is the most compliant vessel (due to the large amount of elastic fibers) the aortic pulse pressure is much greater than the pulmonary pulse pressure."

If pulse pressure is *inversely* proportional to compliance, then the more compliant vessel should have the *lower* pulse pressure.

So which of these two statements is the correct one? —Preceding unsigned comment added by Kevin k (talk • contribs) 21:58, 20 September 2008 (UTC) The second statement is correct. In simple terms, "compliant" means that such a blood vessel easily expands when blood flows into it, so that pressure increases only little. Therefore the difference between systolic (pumping phase of the heart) and diastolic (filling phase of the heart) pressure remains relatively small, if a blood vessel has a high compliance. This is mathematically described by an "inverse relationship". —Preceding unsigned comment added by 83.77.72.36 (talk) 11:13, 16 November 2009 (UTC)

The aorta is the most compliant vessel in the SYSTEMIC circulation. However, the pulmonary vessels (in the pulmonary circulation) are much more compliant and thus the pulse pressure is lower. I made a minor change that I hope clarifies this issue. MedGME (talk) 10:54, 18 December 2022 (UTC)

Folic acid lowering pulse pressure?

that section at the end of the article is silly, it cites a poorly designed study in a low tier journal with 20 patients. I would not include such preliminary research in this article, pulse pressure is an important topic. - adam, neurologist — Preceding unsigned comment added by 128.95.147.56 (talk) 15:51, 3 December 2013 (UTC)

Agree. That is not settled science and thus has no place in this article. I have removed it. MedGME (talk) 10:55, 18 December 2022 (UTC)

Close paraphrase or copyvio

Earwig triggered on a site that derives content from WP, but this paraphrasing may need to be looked into further:

The aorta has the highest compliance in the arterial system due in part to a relatively greater proportion of elastin fibers versus smooth muscle and collagen. This serves the important function of damping the pulsatile output of the left ventricle, thereby reducing the pulse pressure. If the aorta becomes rigid in conditions such as arteriosclerosis or atherosclerosis, the pulse pressure would be very high.—WP

In the arterial system, the aorta has the highest compliance, due in part to a relatively greater proportion of elastin fibers versus smooth muscle and collagen. This serves the important function of dampening the pulsatile output of the left ventricle, thereby reducing the pulse pressure [...]. If the aorta were a rigid tube, the pulse pressure would be very high.  — current reference #3

It could be that the copying went in the other direction, but then why is it being used as a reference? — jmcgnh^{(talk) (contribs)} 06:17, 21 October 2017 (UTC)

The most common cause of a low (narrow) pulse pressure is a drop in left ventricular stroke volume.

I guess a lot of people who read this page (like me) have a low pulse pressure or we would not go here. So what is "drop in left ventricular stroke volume", is it serous? Is it normal? If You are otherwise healthy, can it be an indicator of a heart-problem?

I think this need some more explanation.  — Preceding unsigned comment added by 14.207.18.101 (talk) 09:25, 9 December 2017 (UTC) 

systolic blood pressure % calculation error

I suggest to change the Systemic pulse pressure "Calculation" from the existing:

normal 120mmHg - 80mmHg = 40mmHg or 66% to the correct
normal 120mmHg - 80mmHg = 40mmHg or 33% as 40/120=0.3333..x100=33%

SamiAEH (talk) 13:57, 9 August 2019 (UTC)

The percentage calculations have been removed as this does not add to the article and rather make it confusing, no further detail about why these percentages are relevant is provided in the article MedGME (talk) 10:46, 18 December 2022 (UTC)

Why is WIDENING capitalized?

Is WIDENING an acronym or a general word?

If a general word, then shouldn't NARROWING be discussed?

Bcwilmot (talk) 10:02, 14 October 2019 (UTC)

Issue has been addressed. MedGME (talk) 10:47, 18 December 2022 (UTC)

Serious problems with claim that "a pulse pressure of greater than 100 mmHg is high or widened" in lede

In the lede it is claimed that "a pulse pressure of greater than 100 mmHg is high or widened." Common sense should dictate that the cut-off for pulse pressure being too high is at levels far lower than 100. For example, by this claim, then someone with a pulse pressure of 80 is totally normal, but think about it: in order to have a pulse pressure of 80 then your systolic would have to either be hypertensive or your diastolic would have to be hypotensive.

To give an illustration of what I'm trying to say: To have a pulse pressure of 80 with a systolic of 130 (lowest possible systolic level to be hypertensive), then your diastolic would have to be 50 (130 minus 80 = 50), which would be hypotensive. Likewise, if someone had a systolic of 90 (lowest possible systolic level to not be hypotensive) then to have a pulse pressure of 80, their diastolic would be 170 (90 plus 80 = 170), which is approaching hypertensive crisis. So, obviously it is not possible to have a pulse pressure of 80 without being either hypertensive or hypotensive based on systolic and diastolic, and quite likely if someone has a pulse pressure of 100 then they are simultaneosly severely hypertensive by systolic and severely hypotensive by diastolic at the same time!

The claim about "a pulse pressure of greater than 100 mmHg is high or widened" is also contradicted by other cited claims in the article that claim pulse pressures of either 50+ or 60+ as being pathologically high. It makes a lot more common sense that 50 or 60 would be a more logical cutoff level for pulse pressure to be too high/wide than 100.

Perhaps what is meant to be said is that a pulse pressure of 100 is when it is at a level of being an immediate medical emergency, similar to how hypertensive crisis is a medical emergency, instead of that 100 is when it begins to just be "normal" too high? If so, then this really needs to be clarified, because as it is currently written it could potentially cause dangerous or even deadly consequences to a reader who came across this article due to concerns about their own blood pressure. Vontheri (talk) 02:07, 25 June 2023 (UTC)

I agree with your analysis and revised the lede here to state it simply. Feel free to edit further for better clarification.

In the previous version, the statement "A pulse pressure that is less than 25% of the systolic pressure is inappropriately low or narrowed, whereas a pulse pressure of greater than 100 is high or widened" is plagiarized from the Homan reference, and was oddly worded, so I removed it.

Pulse pressure is rarely the focus in cardiovascular clinical or government guidelines on blood pressure, e.g., the US CDC, where systolic and diastolic pressures are simple and clear enough indicators. Zefr (talk) 02:58, 25 June 2023 (UTC)

@Zefr: Thank you. Your revision is much better. I have also gone ahead and made [this omission] from the "from exercise" section of the article, as it also made the same claim about a pulse pressure of 100.

I'm certainly aware that systolic and diastolic, and not pulse pressure, are almost always the sole focus clinically and in government guidelines regarding blood pressure, but in my opinion pulse pressure should be given much more attention than it currently is, as there is mounting evidence that it is a very important risk factor, and perhaps even more important of a risk factor than systolic and diastolic. Government guidelines can often lag the evidence by years if not decades. See this quote "Pulse pressure has been more strongly associated with cardiovascular outcomes, especially myocardial infarction and heart failure, than has systolic, diastolic, or mean arterial pressure in a variety of populations." from this link and note the studies listed in references 1 through 9 on the link. Also note that the oldest of those nine studies was from 1994, which is very recent compared to the earliest studies examining the negative effects of elevated diastolic and systolic pressures. My prediction is that within twenty or thirty years or so (hopefully much sooner, but just being realistic...) there will be more attention paid to pulse pressure clinically. (You may also be interested in this journal article regarding the topic.)

I similarly think that not enough attention is paid clinically to central aortic blood pressure, especially given that there are now non-invasive and affordable (at least affordable for clinics and hospitals, and for many patients) methods of indirectly, but apparently quite accurately, measuring it. But that's another topic, obviously... Vontheri (talk) 13:01, 25 June 2023 (UTC)