You must have heard a lot about Blood Pressure, or "pressure" as we call it? Maybe someone in your family has it. But, you may not have heard much about 'Pulse Pressure' . This is also a very important thing that says a lot about the health of our heart. So, today we will simply talk about what this 'Pulse Pressure' is, how it affects our health , what happens if it increases or decreases, and what we need to do to keep it at a good level.
What is 'Pulse Pressure'?
Simply put, when you measure your blood pressure, you get two values. One is the top number, which is called 'Systolic Pressure' . The other is the bottom number, which is called 'Diastolic Pressure' .
Think about it, our heart is like a water pump. It pumps blood throughout our body every second.
- Systolic pressure, or the top number , is the maximum pressure exerted on the walls of your arteries when your heart contracts (i.e. beats) and pushes blood through the arteries to the body.
- 'Diastolic Pressure', or the bottom number , is the lowest pressure inside the arteries while the heart contracts and then relaxes again, that is, between two heartbeats.
So, 'Pulse Pressure' is the difference between the top number (Systolic) and the bottom number (Diastolic). This gives us some indication of the health of our heart and blood vessel system.
How to find 'Pulse Pressure'? It's very easy!
There's no need to do any fancy math to figure this out. The value you get when you subtract the top number (Systolic) from the bottom number (Diastolic) of your blood pressure is called 'Pulse Pressure'.
For example, let's think:
Your blood pressure is 120/80 mmHg (millimeters of mercury).
Then the 'Pulse Pressure' becomes:
120 (Systolic) - 80 (Diastolic) = 40 mmHg .
Generally, we consider a healthy adult's pulse pressure to be around 40 mmHg.
But remember, as we age, our arteries stiffen a bit, meaning they lose their flexibility. This is natural. This arterial stiffness is especially noticeable in people with diabetes mellitus and chronic kidney disease .
As these arteries lose their flexibility and become stiffer, usually after the age of 50, this is what happens:
- Your Systolic Blood Pressure (the top number) starts to increase gradually.
- Your diastolic blood pressure (the bottom number) will start to decrease gradually.
This is why pulse pressure increases as we age.
Why does the 'Pulse Pressure' change every few minutes when I check my blood pressure?
Yes, it is very normal for your pulse pressure to vary slightly. We call this 'Pulse Pressure Variation'. Just think, even when you breathe, the amount of blood your heart pumps varies slightly. These variations are usually as small as 5 mmHg to 10 mmHg. Also, depending on the time of day and your position (standing, sitting, or lying down), your blood pressure and pulse pressure can vary slightly from moment to moment. So don't worry too much if you see it once.
What is 'Wide Pulse Pressure'? Is it dangerous?
A wide pulse pressure, or high pulse pressure, means there is a large difference between the top and bottom readings of your blood pressure. A high pulse pressure, usually in someone who is not very physically active , can be a sign of a current or potential health problem.
Doctors generally consider a pulse pressure of more than 100 mmHg to be 'widened' (very high) . However, if your pulse pressure starts to rise above the normal value of 40 mmHg, even a small increase can increase your risk of developing problems with your heart and blood vessels.
Consider this: Research has found that for every 10 mmHg increase in your 'Pulse Pressure', the risk of developing 'Coronary Artery Disease' increases by about 23%.
If your pulse pressure is 50 mmHg or higher, you may be at increased risk of:
- Heart disease
- Heart rhythm disorders ('Arrhythmia')
- Stroke
Also, high pulse pressure values can increase the damage to the eyes and kidneys caused by diseases like diabetes.
However, people who are very physically active, such as long-distance runners, may also have an increased 'Pulse Pressure'. But doctors do not consider it a big problem. This is because their hearts pump more blood than the average person. Also, because they exercise regularly, their arteries are flexible and healthy.
What are the causes of 'Wide Pulse Pressure'?
- Aortic valve (a main valve in the heart) is leaking or narrowing.
- 'Atherosclerosis' - This means that the arteries become narrowed and hardened due to the deposition of fat in the walls of the arteries.
- Sometimes, a 'Wide Pulse Pressure' can also be seen in hospitalized people when they have an infection or inflammation .
What is 'Narrow Pulse Pressure'?
A 'Narrow Pulse Pressure' or low 'Pulse Pressure' value means that your 'Pulse Pressure' is less than one-fourth (1/4) of your Systolic Pressure (the top number).
A situation like this occurs:
- When your heart is not pumping blood properly. For example, in cases like 'Heart Failure' (weakening of the heart's function) and 'Cardiac Tamponade' (a condition where fluid builds up around the heart) .
- Also, this can happen if there is internal bleeding from an accident or if a lot of blood is lost from the body.
Why is it important to properly manage 'Pulse Pressure'?
It is very important to keep your pulse pressure in check. A high pulse pressure can mean that your heart is working harder than usual, or that your arteries are not as flexible as they should be, or both.
Both of these problems greatly increase your risk of serious heart and circulatory problems, such as a heart attack or stroke. This risk is especially high for people over the age of 55 , because at that age, both problems are more likely to occur together.
What should I do to keep my pulse pressure at a good level?
Managing your 'Pulse Pressure' and keeping your overall blood pressure in check are not two things, they are one. So, there are many things you can do to keep your blood pressure in check:
- Get a medical checkup at least once a year: High blood pressure and related problems often do not show symptoms until the disease becomes very serious. Just like our uncle Sunil, I thought he had no disease. But it was during the annual checkup that I realized that the pressure was a little high. Then I was able to control it quickly. Therefore, it is very important to see your doctor at least once a year and get a checkup, so that if there are any problems, you can identify them quickly.
- Eat nutritious foods: A diet low in salt (sodium) can help control your blood pressure. Your doctor will probably tell you to limit your salt intake to 2,300 milligrams a day. That's less than a teaspoon.
- Stay active: Physical exercise is good for your heart and blood circulation. Aerobic exercise (such as walking, running, and cycling) is especially beneficial. Try to exercise for at least 30 minutes a day.
- Limit your alcohol intake: Women should have no more than one alcoholic drink per day (no more than 7 per week) and men should have no more than two alcoholic drinks per day (no more than 14 per week). Drinking more than that can increase your blood pressure.
- Know your risks: If anyone in your family has heart disease, high blood pressure, diabetes mellitus, or high cholesterol, tell your family doctor. If anyone in your family has any of these, you may be at increased risk of developing one or more of them.
- Take your prescribed medication exactly as prescribed: If your doctor diagnoses your blood pressure and prescribes medication, take it exactly as prescribed, at the times prescribed. If you only take your medication when you remember, or only the day before your appointment, you could be at risk of future problems.
- Check your blood pressure at home: If you want, you can check your blood pressure at home. You can buy a 'Blood Pressure Cuff' from a pharmacy or online. By regularly checking your blood pressure, you can find out if your blood pressure is consistently higher than normal. You can then talk to your doctor about it.
When should I see a doctor about my pulse pressure?
If you regularly measure your blood pressure at home, it's a good idea to see a doctor and talk about it if you see something like this:
- If your 'Pulse Pressure' is consistently abnormally 'wide' (i.e. 60 mmHg or higher).
- If your 'Pulse Pressure' is consistently 'narrow' (that is, your 'Pulse Pressure' is less than one-fourth (1/4) of your upper limit).
Sometimes, when you see your blood pressure readings going up and down, you can't figure out what's going on. In such cases, talk to your family doctor. He or she can explain to you whether it's just a normal part of getting older or if it's due to some other health condition.
Your pulse pressure helps doctors learn more about the health of your heart and blood vessels. If you have any questions about your pulse pressure or blood pressure, the best person to ask is your doctor. He or she can answer your questions and refer you to other specialists if necessary. That way, you can have a better idea of what to expect next.
What is the most important thing we want to take home from this story? (Take-Home Message)
Okay, so we've talked a lot about 'Pulse Pressure' today, haven't we? Here are the main things to remember:
- Pulse pressure is an important measure of the health of your heart and blood vessels. It's not just a number.
- Don't be alarmed if you see a one-time increase or decrease in your pulse pressure when you check your blood pressure at home. However, if you continue to see such changes, talk to your doctor about it.
- A healthy lifestyle is the key. Things like eating well, exercising, and limiting alcohol consumption can help keep not only your pulse pressure, but your overall health in good shape.
- Your doctor is your best advisor. Talk to him or her about any questions or concerns you have. Do not self-diagnose.
So, pay attention to your 'Pulse Pressure' as well. It could be a story your heart is telling you!
` pulse pressure, blood pressure, systolic, diastolic, heart disease, health, Sri Lanka
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