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Updated: Dec 7, 2025
Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness
Published on: May 3, 2018
Wide pulse pressure: A clinical review
Kevin S Tang1, Edward D Medeiros1,2,3, Ankur D Shah1,2,3
1The Warren Alpert Medical School of Brown University, Providence, RI, USA.
Insights
Widened pulse pressure, common with aging, signals poor cardiovascular health and increased mortality risk. Controlling pulse pressure may improve outcomes beyond standard blood pressure treatment.
Area of Science:
- Cardiology
- Vascular Medicine
- Gerontology
Background:
- Pulse pressure naturally widens with age due to vascular stiffening.
- Wide pulse pressure is linked to increased mortality and adverse outcomes in chronic diseases.
- Current hypertension treatments may not adequately address pulse pressure as an independent risk factor.
Purpose of the Study:
- To review the causes, pathogenesis, and treatment of widened pulse pressure.
- To evaluate pulse pressure as a predictor of clinical outcomes.
- To discuss the role of pulse pressure control in antihypertensive therapy.
Main Methods:
- Literature review of pathogenesis, causes, and treatments for widened pulse pressure.
- Evaluation of existing evidence on pulse pressure as a clinical outcome predictor.
- Analysis of antihypertensive agents' efficacy in pulse pressure control.
Main Results:
- Widened pulse pressure is associated with increased mortality and disease progression.
- Thiazide diuretics and long-acting nitrates show promise for pulse pressure control.
- Further research is needed to confirm benefits of pulse pressure control over conventional therapy.
Conclusions:
- Widened pulse pressure is a significant indicator of cardiovascular health deterioration.
- Targeting pulse pressure may offer additional benefits in managing hypertension and chronic diseases.
- Optimizing pulse pressure management requires further investigation and clinical trials.
Abstract:
Pulse pressure naturally increases over time as individuals' age due to arteriosclerosis and diffuse vascular stiffening. However, the differential for widened pulse pressure is broad and includes causes of hyperdynamic circulation and high-output heart failure, such as aortic regurgitation and hyperthyroidism. In the absence of an underlying cause, wide pulse pressure is a sign of deteriorating cardiovascular health and carries increased risk for mortality, disease progression, and adverse clinical outcomes in chronic diseases including cardiovascular disease and chronic kidney disease. Current emphasis of antihypertensive treatment on systolic and diastolic blood pressure does not always address pulse pressure, thus subjecting many patients to an independent risk factor for poor outcomes. Pulse pressure control is more successfully achieved with thiazide diuretics and long-acting nitrates when compared to other antihypertensive agents, but further research is needed to quantify the additional benefits of pulse pressure control over conventional blood pressure therapy. This case review provides an overview of the pathogenesis, pathologic causes, and treatment of widened pulse pressure and evaluates current evidence for pulse pressure as a predictor of clinical outcomes.
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