Medically reviewed by Christopher Lee, MD
When you get your blood pressure checked, you'll receive two numbers. These two numbers are your systolic blood pressure (the number at the top) and your diastolic blood pressure (the number on the bottom). Your pulse pressure is the difference between these two numbers. While pulse pressure varies from person to person, having a pulse pressure that is too wide or too narrow can increase your risk of heart disease, heart attack, and stroke.
How To Measure Pulse Pressure
Pulse pressure is the difference between your upper (systolic) and lower (diastolic) numbers in a blood pressure reading. You can calculate your pulse pressure by subtracting the diastolic number from the systolic number. It's worth noting that your pulse pressure is not the same as your pulse (or, heart rate), which measures the number of times your heart beats per minute.
For example, a standard blood pressure is 120/80 mmHg (millimeters of mercury). The difference between the systolic and diastolic blood pressure (120 minutes 80) equals 40, which is the pulse pressure. Experts consider 40 mmHg to be the ideal pulse pressure.
Significance of Blood Pressure and Pulse Pressure
When you take a blood pressure reading, the most important information is finding the range your systolic and diastolic numbers are in. If your blood pressure reading is elevated, you may have or be at risk for hypertension—also known as high blood pressure. Hypertension is one of the leading risk factors for heart disease, kidney disease, and stroke.
On the other hand, if your blood pressure reading is too low, you might have hypotension—which is low blood pressure. Hypotension can cause symptoms like dizziness, blurry vision, confusion, and body weakness. In severe cases, very low blood pressure may occur due to severe infections, massive blood loss, anaphylaxis as well as other medical conditions.
Pulse pressure is less often talked about, but can provide helpful information about your health—particularly if your pulse pressure is very high or very low. Pulse pressure can indicate certain problems with your heart, such as leaking in your arteries (blood vessels) or heart failure. Studies have also shown that having a wide pulse pressure can increase your risk of heart disease.
Narrow vs. Normal vs. Wide Pulse Pressure
Experts estimate that an ideal pulse pressure is around 40 mmHg. It's worth noting that a normal or healthy pulse pressure range can vary. What's more important is to understand what makes a high or "wide" pulse pressure and what's considered a low or "narrow" pulse pressure.
A wide pulse pressure occurs when your pulse pressure is more than 60 mmHg. For example, a blood pressure reading of 145/80 mmHg (or, a pulse pressure of 65) can indicate a wide pulse pressure.
Your pulse pressure may be narrow if your pulse pressure measurement is less than 25% of your systolic blood pressure. For instance, a blood pressure reading of 120/95 mmHg (which is a pulse pressure of 25) is narrow because 25% of a systolic blood pressure of 120 is anything less than 30.
Wide Pulse Pressure
A wide pulse pressure can often occur in young and healthy athletes whose hearts contract to eject blood quickly. This phenomenon is known as athlete's heart. Other causes of wide pulse pressure include:
Atherosclerosis: Otherwise known as the stiffening of the heart's arteries, this can happen when plaque builds up in the blood vessels. This condition is common as you age or if you receive a diagnosis for metabolic syndrome. Stiffened arteries can lead to an increase in systolic blood pressure and a decrease in diastolic blood pressure.
Aortic regurgitation: Leakiness in one of your heart's valves can cause blood to pump backward into the heart from the aorta (the large blood vessel that leads out of the heart to deliver blood to the rest of your body). This condition can cause a reduction in diastolic blood pressure, which can spread the gap between your systolic and diastolic blood pressure numbers.
Hyperthyroidism: A thyroid disorder that occurs when your body produces too much thyroid hormone. As a result of this increase in thyroid hormone levels, your systolic blood pressure can increase and cause wide pulse pressure.
Narrow Pulse Pressure
Narrow pulse pressure often occurs when your systolic blood pressure becomes weak. This can happen when your heart doesn't pump enough blood and oxygen to the rest of your organs and muscles. This phenomenon is known as low cardiac output. Some other causes of narrow pulse pressure may include:
Heart failure: Your heart doesn't pump enough blood or isn't able to pump blood effectively to sustain your body's needs.
Aortic stenosis: A condition that occurs when the blood vessels between the heart and aorta become narrow, which can limit blood flow when your heart muscle contracts
Cardiac tamponade: This can happen when too much fluid builds up in the sac around your heart—known as the pericardium. Cardiac tamponade can also lead to low cardiac output.
How to Manage Pulse Pressure
You can prevent some causes of abnormal pulse pressure by keeping your heart healthy and managing other conditions (like hypertension) that can compromise your heart health or lead to wide or narrow pulse pressure.
The American Heart Association recommends important lifestyle factors to keep a healthy heart, including:
Eating a heart-healthy diet that's rich in fruits, vegetables, legumes, and whole grains
Limiting foods that are high in sodium and saturated fats
Getting regular physical activity and movement throughout the week
If you have a wide or narrow pulse pressure or have concerns about your overall blood pressure, talk to your healthcare provider for support. They can offer individualized tips to keep your blood pressure in control or recommend lifestyle changes that can improve pulse pressure.
A Quick Review
Pulse pressure is the difference in number between your systolic and diastolic blood pressure. Experts recommend that an ideal pulse pressure is 40 mmHg. But having a wide pulse pressure or a narrow pulse pressure can be a sign of a health condition that can affect your overall heart health.
The cause of abnormal pulse pressure can vary but may include stiffened arteries, heart failure, or thyroid disorders. Fortunately, treatments are available to help keep both your blood pressure and pulse pressure in check. Eating a heart-healthy diet and incorporating movement or physical activity into your daily life can help improve pulse pressure.
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