#cardiology See: [Wide pulse pressure: A clinical review - PMC](cubox://card?id=7228019469489015200) ## high pulse pressure >- a consistently wide pulse pressure is a *significant independent predictor* of all-cause, cardiovascular — in particular, coronary — mortality >- patients with simultaneously diastolic pressure < 60 and pulse pressure > 60 have 2x risk of subclinical *myocardial ischaemia* , 5x risk of [[Stroke|CVA]] >- ↑ risk of [[Atrial fibrillation|AF]] >- Nearly all coronary perfusion and more than half of cerebral perfusion occurs during diastole, thus a diastolic pressure that is too low can cause harm to both the heart and the brain - reduced arterial compliance / atherosclerosis - [[Valvular disorders#Aortic Regurgitation]] - Aortic sclerosis - [[Heart Block]] with bradycardia - [[thyrotoxicosis|hyperthyroidism]] - Fe-def [[Anaemia]] - [[traumatic brain injury]] (cushings triad) and ↑ ICP - [[Aortic dissection]] - PDA - endocarditis - Distributive shock - Fever - Pregnancy - Exercise ## low pulse pressure > - usually systolic decreasing with diastolic staying same, leading to ↓ pulse pressure > - A pulse pressure is considered abnormally low if it is less than 25% of the systolic value. > - Extremely low pulse pressure eg <25 mmHg concerning for low stroke volume eg *congestive heart failure* - low stroke volume from [[Congestive Heart Failure]] - [[Aortic stenosis]] - [[tamponade]] - Hypovolaemic shock