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Question:

Am I at risk because of high pulse pressure?

I hear a lot about pulse pressure and high pulse pressure in particular. I am a 69 YO ex-marathon runner who averaged running 40 miles/week for over 20 years. Mt resting pulse rate is 50-60 BPM and my BP runs 120/60 on average. Looking at charts, this is considered to be high pulse pressure, putting me at risk for stroke & heart attack. I have received a completely negative heart cath in May 2010. In the case of an athletic heart, is this high pulse pressure or merely the result of high stroke volume or cardiac output?

submitted by Fred from Arthur City, Texas on 8/27/2012

Answer:

by Texas Heart Institute cardiologist, Domingo G. Gonzalez, Jr., MD    Domingo G. Gonzalez, Jr., MD

Prior to knowledge of your specific situation, when looking at populations, a high pulse pressure can be identified as associated with higher incidence of stroke and heart attack. The mechanism is not clear but could be associated with a higher shear stress on diseased arteries. If you have been shown to have a normal set of arteries going to your heart and brain, then you have been taken out of the population that was used to determine whether high pulse pressure was associated with higher heart attacks and strokes. It does not apply to you since you have a knowledge that your arteries are normal and you are no longer a  member of a random and unknown population. However, an invasive coronary angiogram can only tell you if there are luminal irregularities or stenosis. A person may have plaque build up that is not seen on standard angios because they don't yet cause luminal irregularities. Only multidetector ct coronary angios or intravascular ultrasound can tell you if your arteries are free of plaque completely.        

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Updated September 2012
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