[Medical Q&A] Why do elderly people have high pulse pressure?

Planner: Chinese Medical Association

Reviewer: Liu Li, Chief Physician, Union Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology

Pulse pressure is the difference between systolic and diastolic pressures. The normal pulse pressure range is generally 20-60 mmHg, which is easily affected by many factors. A large amount of research data shows that with the increase of age, the systolic blood pressure level is also rising, while the diastolic blood pressure shows a downward trend, which leads to a gradual increase in pulse pressure. Among elderly hypertensive patients, the most common clinical manifestation is the increase in systolic blood pressure.

Slower heart rate, increased cardiac output, reduced vascular compliance, and increased age can all increase pulse pressure. Among them, age is the main influencing factor, because with age, the thickness of the intima-media layer of the artery will gradually increase, vascular elasticity will decrease, and compliance will decrease, leading to arteriosclerosis. Increased pulse pressure will affect the perfusion pressure of the coronary arteries, leading to myocardial ischemia and even cardiovascular and cerebrovascular malignant events such as myocardial infarction. In general, for every 10 mmHg increase in pulse pressure in elderly hypertensive patients, the risk of stroke will increase by 11%, and the possibility of death will also increase by 16%. If the pulse pressure is greater than 60 mmHg, this may be the main risk factor for renal insufficiency in elderly patients with essential hypertension.