Well here is one Dr that doesnt think pulse pressure is significant unless one is having a heart 'incident' - REALLY
I kinda like Amy taking the prior Dr to task, I read his comment (not included) here and thought he was very arrogant and did not give good advice.
moneysaver3 - Wed Jun 30, 2010 7:51 pm
John,
Might I suggest that you only give advice if you are 100% sure what the poster is talking about?
She is not talking about low BLOOD PRESSURE. She is talking about low PULSE PRESSURE. There is a difference. A HUGE difference.
Also, it's not really a good idea to tell someone to quit being stressed and to quit focusing on their body! That's not your job! You have not seen that person personally and shouldn't be saying such things!
The reality is that low PULSE pressure (which she CLEARLY DOES have) IS something that can be of concern. It might not be, but it CAN be!
Amy
Dr. Tamer Fouad - Sat Jul 03, 2010 6:20 am
Hello Amy!
Thank you for your input. However, I am a little disappointed at the way you chose to express your concern and opinion. John, like everyone else here is a volunteer that tries his best to answer questions to the best of his knowledge for free. His work here is appreciated by everyone.
You have made an interesting comment which is why I am responding back. The definition of pulse pressure is directly related to blood pressure. The pulse pressure is defined as the systolic minus the diastolic pressure. One definition of the normal range for pulse pressure is between 25-50% of systolic blood pressure. Widened (elevated) pulse pressure is much more important with blood pressure readings taken from the general population (screening). These can indicate stiffening of the major arteries or conditions with increased cardiac output / hyperdynamic circulation.
In contrast, a low pulse pressure (definitions in the literature vary from 40 to 45mmHg) is only relevant in the setting of acute decompensated
heart failure and possibly also in congestive
heart failure. But, let me stress: in these two settings the low pulse pressure is important not from a diagnostic point of view but only from a prognostic angle. We NEVER diagnose these conditions by using low pulse pressure. This is because low pulse pressure is neither specific nor sensitive as a diagnostic test for these conditions. However, the finding of low pulse pressure in a patient with acute decompensated
heart failure is related to the patient's expected survival as suggested by some studies.
There are three issues with the post that I am sure John was completely aware of when assessing his response to this question.
First, the notorious inaccuracy of home blood pressure readings. In order to assume that a patient has any blood pressure disorder this should be done by trained personnel using a professional blood pressure reading device.
Second, the lack of consistency in the readings is extremely important. When we say low pulse pressure has a prognostic significance in patients with
heart failure we mean a CONSISTENTLY low pulse pressure.
Third, for the sake of the argument, were we to assume the patient has a clinically significant and consistent low pulse pressure and that this COULD be somehow related to something as serious as
heart failure then other symptoms would predominate. The patient must have a significantly low blood pressure and a very
rapid heart rate. In addition to other failure symptoms such as
shortness of breath, etc.
Let me take this opportunity to insist that no one here offers any medical advice. We hope to educate and inform our visitors by answering their questions.