Wide Pulse Pressure Causes:
The narrow pulse pressure (wide pulse pressure) is caused by narrowing of the blood vessels. When there are too many arteries in your body, they restrict blood flow through them. If you have narrowed arteries, it means that the blood supply to your heart will not be sufficient to pump enough oxygenated blood throughout your body. Your heart beats less efficiently than usual and you may experience shortness of breath or even collapse if left untreated.
In addition, when there are too few arteries in your body, it means that the blood supply to your heart will not be sufficient to pump enough carbon dioxide into your bloodstream. Carbon dioxide is essential for keeping your blood at a proper temperature. Without CO2, you would die of hypoxia.
As you probably already know, narrow pulse pressure is also known as wide pulse pressure (WPP). Wider pulse pressure is usually due to a blockage in one of the main veins supplying blood to your heart. In most cases, narrow pulse pressure is due to a blockage in a vein leading from the right upper arm artery (AV node), which supplies blood directly to the heart. However, it can also result from other sources such as a blocked artery in another part of your body or even an obstruction in your lungs.
The condition narrow pulse pressure is a life-threatening condition that can cause you to go into shock and may even result in sudden death. It usually occurs because of an accident or injury (such as a heart attack), but it may also occur spontaneously due to other causes such as being born with a genetic defect. Narrow pulse pressure is not curable, but it is manageable.
There are many potential causes of narrow pulse pressure. For example, prolonged sitting or standing without movement and a lack of physical exercise can cause your arteries to become narrower and restrict blood flow, which may lead to narrow pulse pressure. It may also be caused by increased arterial plaque deposits, which narrows your arteries and restricts blood flow. In addition, narrowing of the aortic valve or the heart (due to a heart attack) can also cause narrow pulse pressure.
Certain diseases, such as Marfan Syndrome or Ehlers-Danlos Syndrome, can also result in narrow pulse pressure.
If left untreated, narrow pulse pressure can cause serious health complications. For instance, it can cause chest pain (known as angina), an irregular heartbeat, a heart attack or a heart failure. If you have narrow pulse pressure, you should avoid sitting or standing in the same position for too long and should try to engage in regular physical exercise. You should also check with your doctor to rule out potential medical problems that can lead to narrow pulse pressure, such as aortic stenosis.
Narrow pulse pressure can be either congenital or acquired. Congenital narrow pulse pressure is present at birth, while acquired narrow pulse pressure develops later in life. It can affect virtually anyone and the exact cause is usually not known.
Acquired narrow pulse pressure most commonly occurs because of an arterial occlusion caused by atheroma (plaque build-up). This is most often due to atheroma of the large arteries or aorta, but it may also be due to atheroma in the smaller branching arteries (such as iliac or renal arteries). It can also occur when there is complete blockage of an artery due to an embolism.
Acquired narrow pulse pressure can also be caused by disease. For example, it can occur secondary to an autoimmune disease such as systemic lupus erythematosus or scleroderma, or due to another type of vasculitis (inflammation of the blood vessels). It can also be caused by diseases that affect the heart such as hypertrophic cardiomyopathy or aortic stenosis.
Narrow pulse pressure can also be caused by a vasospasm. A vasospasm is a sudden contraction of the muscular walls of an artery, which reduces the diameter of the artery and decreases blood flow. It usually occurs in the middle of the night, causing sleep disruption (night angina). When this occurs in an artery leading to the brain, it can cause a transient ischemic attack (TIA) or a stroke.
A vasospasm may occur spontaneously or due to certain drugs such as ergot alkaloids, serotonin agonists (such as tandospaz and tramadol), or stimulants (such as diet pills containing phenylpropanolamine)
Narrow pulse pressure can also be congenital. Congenital narrow pulse pressure is present at birth, although it may not be diagnosed until later in life. Congenital narrow pulse pressure is most often due to a congenital narrowing of the aortic valve or innominate artery. For example, in a condition known as aortic coarctation, the opening in the aorta that allows blood to flow through the aortic valve is narrowed.
This causes blood to back up and leads to high blood pressure in the lungs and other parts of the body (this is known as Eisenmenger syndrome). It can also be due to a narrowing of the valve between the left ventricle and the aortic artery (aortic valve stenosis) or between the left atrium and the ventricle (mitral valve stenosis).
Narrow pulse pressure can also be caused by an arterial occlusion (blockage) caused by atheroma (plaque build-up). This most commonly occurs in the carotid arteries that supply the brain, the coronary arteries that supply the heart, or the iliac arteries that supply the legs.
Narrow pulse pressure can also occur secondary to an irregular heart rhythm (arrhythmia) such as atrial fibrillation, which causes the heart to beat too fast and irregularly.
Narrow pulse pressure can also be caused by a number of other conditions, such as obesity, pregnancy, or tumors.
Risk factors for acquired narrow pulse pressure include aging (because of the normal hardening of the arteries that occurs with aging), smoking, high blood cholesterol, and diabetes mellitus.
Sources & references used in this article:
Genome-wide association study identifies six new loci influencing pulse pressure and mean arterial pressure by LV Wain, GC Verwoert, PF O’Reilly, G Shi, T Johnson… – Nature …, 2011 – nature.com
Understanding nonresponders of cardiac resynchronization therapy—current and future perspectives by CMAN YU, J WING‐HONG FUNG… – Journal of …, 2005 – Wiley Online Library
Genome-wide scan for pulse pressure in the National Heart, Lung and Blood Institute’s Framingham Heart Study by AL DeStefano, MG Larson, GF Mitchell… – …, 2004 – Am Heart Assoc
Genome-wide linkage analysis for loci affecting pulse pressure: the Family Blood Pressure Program by SJ Bielinski, AI Lynch, MB Miller, A Weder… – …, 2005 – Am Heart Assoc
