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Pulse Pressure & PVR
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Pulse Pressure & PVR

Hi, I am a University student studying for my Registered Nursing degree. I am currently studying the heart, specifically a case study on a patient with CHF. I am a little confused about Pulse Pressure and its relation to Pulmonary vascular resistance. This patient has a BP reading of 185/60 - therefore his PP would be 125 - the difference between systolic & diastolic readings. Does this mean that PP has increased (as the 125 is way out of normal range of 35 - 50) as it appears or does it mean that pulse pressure actually lessons and becomes less effective as the pulse pressure widens? This is probably basic to you, but the more I study this and the more information I access, the more confused I am becoming.
My basic understanding of BP is - Systolic = the heart ejecting blood into the systemic system, diastolic = the hart at rest, as it refills with blood. When I look at this mans BP reading, it makes me think that his atrium is in AF, so beating really fast and poss erratically, while the ventricle is behaving normally, and is just filling a normal amount of blood, instead of an increased amount as you would expect, to keep up with the atrium. This then looks like the ejection rate has increased, but the fill rate has not, therefore the actual pressure in the circulatory system may have increased, but is less than effective.
With the heart filling at a normal rate, and the heart ejecting at an increased rate, would there be a deficit in blood or too much, as in AF the heart beats too rapidly to eject a decent amount of blood? Also, how does PVR impact on PP? Hope this makes a little sense to someone, as I am very confused, any hlp would be appreciated, thanks Cheers Ally
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Avatar_dr_m_tn
Hi,

The higher pulse pressure can be due to either a stiffness of the blood vessels and especially the larger vessels and thus a reduced elasticity of the vessels. A higher pulse pressure is definitely not a good sign. The other possibility of higher PP is probably due to anemia or hyperthyroidism.

According to the Framingham study, for example, a 65-year-old-man with a blood pressure of 170/70 mm Hg has a risk of stroke, heart failure, or another cardiovascular event that is twice as high as that of another man of the same age whose blood pressure is 170/110 mm Hg (Circulation, vol. 100, p. 354, 1999). The reason is that although the first man's diastolic pressure is low, his pulse pressure (100 mm Hg) is higher than the other man's (60 mm Hg).

Thus, there’s definitely a relation between pulse pressure and peripheral vascular resistance (PVR increases with ageing (aging) and so does the pulse pressure) and thus increases the chances of the cardiovascular disease.
I am not sure of the relation between pulmonary vascular resistance and pulse pressure but hopefully there should be a similar relation.

I hope that helps. Please do keep me posted. Warm Regards.


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