Pulse pressure is an indicator of how stiff or flexible the arteries are and how well the heart pumps blood. Like high blood pressure, high pulse pressure is linked to heart disease.

What Is Pulse Pressure?

Pulse pressure is the difference between your systolic blood pressure (top number) and diastolic blood pressure (bottom number)
For example if your blood pressure is 120/80, your pulse pressure would then be 120-80 equaling 40.

Normal Range
The normal range for pulse pressure is between 40 mmHg and 60 mmHg

(Systolic Blood Pressure) – (Diastolic Blood Pressure) = Pulse Pressure

The pulse pressure essentially tracks how much force the heart creates each time it contracts.

Pulse pressure tends to increase as you age as the arteries become less elastic. High pulse pressure (anything greater than 60 is a major risk factor for heart disease)

Doctors look at pulse pressure to determine how healthy the heart and large arteries are to estimate the risk of heart disease.

Pulse pressure is becoming a major player in the determination of optimal heart health.

Having normal pulse pressure indicates that your heart is pumping blood as it should and your arteries are adapting well by expanding and contracting.

Cardiovascular Complications from Increased Pulse Pressure--aka: Wide Pulse Pressure

Heart Disease
Wide pulse pressure is strongly linked to heart disease.

One study followed over 11k healthy men for 11 years. In those older than 60 years, pulse pressure above 55 mmHg was linked to more than 40% increased incidence of heart disease compared to levels below 44 mmHg

Congestive Heart Failure
A study in the Journal of the American Medical Association (JAMA) found those with a pulse pressure above 67 mmHg had a 55% increased risk of congestive heart failure compared to those with levels below 54 mmHg.

Stroke

High pulse pressure is as strong a risk factor for stroke as systolic and diastolic blood pressure.
High pulse pressure can damage blood vessels in the brain, leading to a stroke.

A study from the medical journal, Clinical Research in Cardiology found that every 10 mmHg rise in pulse pressure increases the risk of stroke by 5-11%

Erectile Dysfunction

Patients with pulse pressure above 60 mmHg were 15% more likely to suffer from erectile dysfunction. Wide pulse pressure has been found to reduce blood flow in the penis.

Irregular Heartbeat
A wide pulse pressure has been found to contribute to atrial fibrillation.

A study in JAMA found that every 20 mmHg increase in pulse pressure increased the risk of atrial fibrillation by 26%.

Heart Attacks
Wide pulse pressure was linked with more than a 2-fold increased incidence of heart attacks.

In a study from the prestigious medical journal Circulation it was found that every 10 mmHg increase in pulse pressure was linked to a 12% increase in the incidence of future heart attacks

Death
Wide pulse pressure increases the chance of death from heart disease.

In a study from the medical journal, Hypertension it was found that each 10 mmHg rise in pulse pressure increased the risk of death due to heart disease by 20%

As a general conclusion it has been found via several medical studies that like high blood pressure, high pulse pressure is linked with an increased risk of heart disease, heart attack, and dying.

What are the Common Causes of Increase Pulse Pressure (Wide Pulse Pressure)

Hardening of the Arteries
Hardened arteries (atherosclerosis) are the most common cause of wide pulse pressure. As we age, the arteries become stiffer due to the buildup of fatty plaques and calcium.

Overactive Thyroid
An overactive thyroid (hyperthyroidism) has been found to be associated with a wide pulse pressure

Aortic Valve Regurgitation
Aortic valve regurgitation is when the aortic valve doesn't close properly. As a result, blood flows back into the heart, which increases systolic and decreases diastolic blood pressure. In turn, pulse pressure widens.

Anemia
Severe anemia has been found to increase systolic and pulse pressures.

Low Testosterone

Older men with low testosterone have stiffer arteries, which can raise their pulse pressure and blood pressure.

In one study those with pulse pressure above 60 mmHg were twice as likely to have low testosterone levels.

Proven Clinical Recommendations to Lower Pulse Pressure

Exercise
The following exercises have been effective in decreasing pulse pressure

Moderate-intensity aerobic exercise such as brisk walking cycling, rowing, etc.
High-intensity interval training (HIIT)
High-intensity interval training (HIIT involves bursts of intense exercise followed by short rest periods.

A study of 245 people found that 3x/week of HIIT for 8 weeks reduced pulse pressure by 13 mmHg.

** Always consult with your physician before you engage in HIIT type of exercises

Stop Smoking
Smoking stiffens the arteries and increases both blood pressure and pulse pressure

Reduce Sodium Intake
Sodium-rich foods and salt harden the arteries making them stiff contributing to increase pulse pressure.

Reduce Alcohol Consumption

Heavy drinkers will commonly have higher pulse pressure than light drinkers

Lose Weight

According to one study of 220 obese people, a 10% reduction in BMI reduced pulse pressure by 9%

Get Enough Sleep
Make sure you are getting consistent, quality sleep every night.

Eat Beets
In one medical study it was found that beetroot juice reduced pulse pressure by 1.5 mmHg over the course of 24 hours

Eat one ounce of Dark Chocolate every other day (70% or greater is needed)
In a study on 32 healthy people, those eating flavanol-rich chocolate had a lower pulse pressure than those who ate chocolate low in flavanols

Omega-3 Fats
In one study 6 grams of fish oil (1:1 EPA:DHA) daily for 16 weeks decreased pulse pressure and reduced arterial stiffness

Vitamin B9 (Recommend methylated folate)
In one study it was found that supplementing with 4 mg/day methylated folate (vitamin B9) lowered pulse pressure by nearly 5 mm Hg and reduced arterial stiffness

Vitamin K

Vitamin K may help prevent artery hardening reduces pulse pressure

Aged Garlic Extract
Garlic has been found to decrease arterial stiffness and in one study taking 1,200 mg of aged garlic extract reduced pulse pressure by 4 mmHg over the course of 12 weeks

**Recommend Garlic Forte from MediHerb

Dr. Grisanti's Comments:

Pulse Pressure should be added to your cardiovascular assessments and can easily be done at home with a blood pressure monitor. If an increased pulse pressure is found it is important to discuss these findings with your physician and get medical clearance on the above treatment recommendations to improve pulse pressure and of course improved cardiovascular health.

A special thanks to Ronald Grisanti D.C., D.A.B.C.O., DACBN, MS, CFMP

References:

** Always consult with a physician or healthcare practitioner with significant integrative or functional medicine training before starting any of the above recommendations.

You can find a qualified and certified functional medicine practitioner by going to: www.FunctionalMedicineDoctors.com

The information on this website is not intended to replace a one-on-one relationship with a qualified health care professional and is not intended as medical advice. It is intended as a sharing of knowledge and information from the research and experience of Dr. Grisanti and his functional medicine community. Dr. Grisanti encourages you to make your own health care decisions based upon your research and in partnership with a qualified health care professional. Visit www.FunctionalMedicineUniversity.com for more information on our training in functional medicine. Look for practitioners who have successfully completed the Functional Medicine University's Certification Program (CFMP) www.functionalmedicinedoctors.com. This content may be copied in full, with copyright, contact, creation and information intact, without specific permission, when used only in a not-for-profit format. If any other use is desired, permission in writing from Dr. Grisanti is required

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