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Forum Name: Hypertension

Question: Should I be worried about a high pulse pressure?


 timmyc99 - Tue Apr 28, 2009 1:14 pm

I'm a very active 26 y/o male.. I have a resting pulse rate in the 40s and work out ~6 days a week. As far as I can tell, though, I have a fairly high pulse pressure (systolic minus diastolic) - I had a recent bp of 140/60. Should I be concerned about this? I don't have any symptoms at all - no shortness of breath, shaky hands, palpitations, or anything of the sort. Some of it might be related to just being a little whitecoat hypertensive. I've been looking through the literature, but most of it just pertains to elderly patients - there doesn't seem to be much about a younger population. I did find one article which seemed to link high pulse pressure to early cardiac events. I'm a little worried, and was hoping to get some input.
Thanks
 John Kenyon, CNA - Tue May 12, 2009 10:49 pm

User avatar Hi there --

While isolated systolic hypertension (ISH) is fairly common in the elderly, and is considered an inveitable part of aging (a faulty theory I believe, but beside the point in this discussion), in young, athletic types such as you appear to be, it is often a direct function of altered hemodynamics because of fitness level. Since your heart rate is only in the 40s, the heart has more time to refill between beats, so the cardiac output is going to be much greater, thus much higher systolic pressure is a possible logical outcome.

That being said, certain problems could and should be ruled out, such as hyperthyroidism and any causes of unusual stiffening or constriction of the vessels. Both these seem rather unlikely, but it wouldn't hurt to run this by your doctor, just to be safe. I strongly suspect it is increased cardiac output due to extreme fitness level, and probably not problematic. If you should find the systolic pressure creeping on up above 140, however, this would not be right and should be investigated. For this reason I think it probably prudent to bring this to the attention of your doctor now. Bear in mind that with normal/low diastolic pressure, any treatment of the systolic will also lower the diastolic, and there's not much room for that to drop. Wide pulse pressures are, again, often seen in athletes. Just a quick look at a few critical areas should clarify whether there's any reason for concern. I doubt there is, but why take the chance?

I hope this helps answer your concerns. Please follow up with us here as needed. Good luck to you.

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