What is pulse pressure and why do cardiologists care about it?

Pulse pressure is the arithmetic difference between systolic and diastolic blood pressure (e.g., 140/75 = 65 mmHg pulse pressure), it reflects arterial stiffness and aortic compliance, and a pulse pressure above 60 mmHg is associated with significantly elevated cardiovascular mortality, particularly stroke risk, because wide pulse pressure indicates stiff arteries that cannot adequately buffer the cardiac ejection pressure, transmitting the full systolic pulse to the arterial walls and end-organs (Franklin et al., Hypertension, 1999).

Pulse pressure is a more sensitive indicator of arterial aging than either systolic or diastolic pressure alone. A man with blood pressure of 150/60 (PP=90) has a more cardiovascular-aged vascular system than one with 150/90 (PP=60), because the first man's diastolic has fallen, indicating severe aortic stiffness that can no longer maintain diastolic pressure between beats. This is the aging aorta signature: rising systolic, falling diastolic, widening pulse pressure.

Honesty Scale: Solid (1) for pulse pressure as a cardiovascular risk marker reflecting arterial compliance.

What to do: Calculate your pulse pressure from your next home blood pressure reading. Above 60 mmHg pulse pressure is a discussion item for your cardiologist, particularly if you are under 65, because at younger ages, a wide pulse pressure indicates more accelerated arterial aging than is age-appropriate.

For the full picture, read The Blood Pressure Deep Dive