Increased pulse pressure

Introduction Pulse pressure difference is the difference between systolic blood pressure and diastolic blood pressure. The normal range is 20-60 mmHg. Generally, it is larger than 60 mmHg, which is called pulse pressure difference increase, and less than 20 mmHg is called pulse pressure difference reduction. Under normal circumstances, the pulse pressure difference of normal people is 20~60 mmHg (2.67~8.0Kpa). If the blood pressure is greater than 60 mmHg, the pulse pressure difference is too large, and if it is less than 20 mmHg, it is too small. It is generally believed that aortic and other large atherosclerosis, decreased elasticity and extensibility of the arterial wall, are caused by increased blood pressure in the simple systolic phase. The stiffness of the aorta causes the pressure wave to be reflected faster, causing the superposition of the reflected waves to advance to the systolic phase, resulting in a higher systolic pressure wave. When diastolic, the aorta does not have enough elastic retraction to maintain diastolic blood pressure, which causes diastolic blood pressure to decrease, and the pulse pressure difference increases. Common diseases are: essential hypertension, aortic regurgitation, aortic sclerosis, hyperthyroidism, severe anemia, rheumatic heart disease, syphilitic heart disease, partial congenital heart disease and hypertensive heart disease, bacteria Endocarditis and the like.

Cause

At complete atrioventricular block, a slow heart rate can cause increased systolic blood pressure and widened pulse pressure. Chronic aortic regurgitation also widens the pulse pressure. When the patient has atrial or ventricular rhythm abnormalities, the periodic pulse pressure widening is often manifested as RR interval changes.

(1) suffering from hypertension and arteriosclerosis, resulting in weakened arterial wall elasticity, increased systolic blood pressure, and decreased diastolic blood pressure.

(2) Long-term suffering from high blood pressure, causing myocardial overload, causing heart enlargement or insufficiency of the valve.

(3) suffering from hyperthyroidism (hyperthyroidism) or severe anemia.

an examination

Related inspection

Cardiac angiography, cardiovascular diagnosis, echocardiography, electrocardiogram

The mean pulse pressure of the population was (44.61±13.59) mm Hg (1 mm Hg=0.133 kPa), including (44.92±12.72) mm Hg for males and (44.34±14.32) mm Hg for females. Pulse pressure gradually increased with age. Widening, after the age of 50, the pulse pressure is widened and women are higher than men. In the population aged 60 years, the proportion of pulse pressure 60 mmHg is high.

Indirect measurements are used for the measurement of human arterial blood pressure, usually using the assay invented by the Russian physician N. Korotkov. The device consists of an inflatable cuff and a pressure gauge connected to it, and the sleeve is tied to the subject. The upper arm, then pumping to block the blood flow of the brachial artery, slowly release the air inside the cuff, using the stethoscope placed on the radial artery can be heard when the cuff pressure is just less than the brachial blood pressure, the blood flow is over the flattened The vibrational sound caused by turbulence in the arteries (Krottkov, referred to as Coriolis sound) is used to determine the highest pressure during systole, called systolic blood pressure. Continue to deflate, the Coriolis sound increases, and the blood pressure reading measured when the sound becomes low and long is equivalent to the lowest blood pressure at the time of diastole, called diastolic blood pressure, when the deflation into the cuff is lower than the diastolic pressure. At the same time, the blood flow smoothly through the unobstructed blood vessels, and the Coriolis sound disappears.

Because the specific gravity of mercury is too large, it is difficult for the mercury manometer to accurately and quickly reflect the instantaneous changes of blood pressure in each phase of the heartbeat. Therefore, various sensitive membrane manometers can be used to accurately measure the contraction and diastolic blood pressure. In recent years, various transducers have been used in combination with an oscilloscope to more sensitively measure blood pressure.

National authorities issued: normal blood pressure: systolic blood pressure <130mmHg, diastolic blood pressure <85mmHg ideal blood pressure: systolic blood pressure <120mmHg, diastolic blood pressure <80mmHg.

Differential diagnosis

With the widening of pulse pressure, the prevalence of stroke and myocardial infarction also increased. Multivariate logistic regression analysis showed that after adjusting for gender, age, body mass index, smoking, and alcohol consumption, the risk of myocardial infarction with pulse pressure was 1.2, 1.5, and 1.7 times that of the baseline group. The re-analysis of systolic and diastolic blood pressure into the influencing factors still shows that the risk of stroke and myocardial infarction increases with the increase of pulse pressure. Conclusion The prevalence of stroke and myocardial infarction increases with the increase of pulse pressure. Pulse pressure widening is one of the risk factors for stroke and myocardial infarction, especially in the elderly.

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