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What Is Pulse Pressure? - Definition, Variation & Normal Range

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  • 0:00 Definition and Normal Range
  • 1:05 Variation
  • 1:34 Health Concerns
  • 2:55 Lesson Summary
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Lesson Transcript
Instructor
Nadine James

Nadine has taught nursing for 12 years and has a PhD in Nursing research

Expert Contributor
Brenda Grewe

Brenda has 25 years of experience teaching college level introductory biology and genetics. She earned her PhD in Genetics from Indiana University.

In this lesson, you will learn what pulse pressure is, how it is measured, and the ranges of normal levels. Also included will be examples of variations in pulse pressure and how it is related to health.

Definition and Normal Range

Pulse pressure is the difference between the systolic blood pressure and the diastolic blood pressure. The systolic blood pressure is sometimes known to non-health professionals as the top number. It represents the amount of pressure exerted on the blood vessels when the ventricle of the heart contracts (systole).

So, the diastolic blood pressure is the lower number, and it represents the amount of pressure on the blood vessels when the heart is at rest. A heart is at rest when it is between contractions. Normal ranges of blood pressure are less than 120 for systolic and less than 80 for diastolic, according to the World Health Organization.

Pulse pressure is measured by millimeters of mercury (mmHg). Mercury is the only metal that is liquid at room temperature, so it is used to determine measurement of thermometers and barometers. The normal range for the pulse pressure is between 30 to 50 mmHg.

Variation

A few examples of pulse pressure variation in several processes in the body are:

  1. Low blood volume, known as hypovolemia, will increase pulse pressure
  2. Decreased heart rate, known as bradycardia, will increase pulse pressure
  3. Irregular heartbeat, which may cause increased pulse pressure
  4. Control of increased blood pressure, which will usually lower high pulse pressures

Health Concerns

Pulse pressure is thought to be the strongest predictor of heart disease in the elderly. However, this may not be true for other populations.

In lower-than-normal pulse pressures, or below 40 mmHg, a person may have poor heart function. Some causes of this include sustained increased heart rate (above 100), pericardial effusion (an abnormal accumulation of fluid in the pericardial cavity), and ascites (the accumulation of fluid in the peritoneal cavity). Pulse pressure is an important predictor of death in patients that use dialysis for end-stage kidney disease.

Higher-than-normal range pulse pressure can help to predict heart disease, especially in adults over 60 years old. At a pulse pressure of 60 mmHg or greater, the person would be considered at risk for heart disease.

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Additional Activities

Pulse Pressure Activities

As you learned in the lesson, pulse pressure is the difference between an individual's systolic and diastolic blood pressure. Normal pulse pressure ranges between 30 and 50 mm Hg. In people over age 60, an increase or decrease in pulse pressure outside of the healthy range can be an indicator of heart disease or poor heart function.

Matching Activity

Match each of the health conditions/risks listed below to the correct column in the accompanying table.

  • ascites (excess fluid in the peritoneal cavity)
  • atherosclerosis (fat deposits in the aorta)
  • bradycardia (decreased heart rate)
  • excess medication to reduce blood pressure
  • hyperthyroidism (overactive thyroid gland)
  • hypovolemia (low blood volume)
  • pericardial effusion (fluid around the heart)
  • sustained tachycardia (increased heart rate)

Patient Diagnosis Activity

A 61 year old woman checks in at an urgent care clinic complaining of dizziness, especially when she gets up in the morning. On her intake form, she lists all the medications she is currently taking, which includes ibuprofen for joint pain and propranolol as treatment for migraine headaches and essential tremor. Ibuprophen is a nonsteroidal anti-inflammatory drug (NSAID) often used for treatment of arthritis pain and inflammation. Propranolol is a general beta-blocker used to treat chest pain, high blood pressure, heart rhythm disorders, and tremors, as well as to reduce the severity and frequency of migraine headaches. When you take the patient's pulse and blood pressure, she has pulse rate of 48 and BP of 104/56. She reports these as the lower end of normal for her.

Is the patient's pulse pressure outside of the normal range? Is her dizziness likely a result of taking either medication?

Solutions

Matching Solution

Patient Diagnosis Solution

The female patient's pulse pressure is 104 - 56 = 48, so it is within the normal range. Her pulse is lower than typical. Most healthy adults have a resting heart rate of 60-100 beats per minute. A resting pulse rate of 48 is not unusual for healthy athletic individuals, though. A variety of conditions can result in a low heart rate, or bradycardia. These include aging, infection of heart tissue (myocarditis), hypothyroidism, calcium or potassium imbalance in the blood, chronic inflammatory diseases, and long term use of medications for other heart rhythm disorders, high blood pressure and tremor.

Propranolol belongs to a class of drugs known as beta adrenergic blockers or beta blockers. Propranolol affects the activity of epinephrine receptors of cardiac cells, slowing the heart rate of individuals taking it. For individuals over 60 who have taken it a long time, there is risk of the heart beat becoming too low. NSAIDs, like ibuprofen, may decrease the blood pressure-lowering capabilities of propranolol. More information is needed about the patient's health history to determine the exact cause of her dizziness and if it might be due to impaired heart function.

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