{
  "id": "pulse-pressure",
  "version": "6a41bcb5ffdd",
  "status": "published",
  "name": "Pulse Pressure Calculator",
  "question": "What is my pulse pressure?",
  "summary": "Works out the pulse pressure (systolic minus diastolic blood pressure) and the proportional pulse pressure (pulse pressure ÷ systolic), and compares them with the 60 mmHg and 25% cut-offs of the cited sources.",
  "category": "health",
  "subcategory": "clinical",
  "url": "https://www.acalculator.org/health/pulse-pressure-calculator",
  "markdown": "https://www.acalculator.org/health/pulse-pressure-calculator.md",
  "kind": "function",
  "method": "Pulse pressure = SBP − DBP; proportional pulse pressure = (SBP − DBP) ÷ SBP × 100%. Each is rounded once to 1 decimal, halves up, then compared with 60 mmHg and 25%.",
  "assumptions": [
    "The pressures are one cuff reading in mmHg, with the person seated and rested.",
    "The 60 mmHg cut-off is the 2023 ESH sign of stiff large arteries in people over 60; the 25% cut-off comes from 50 people with chronic heart failure.",
    "Each result is worked from the exact typed values and rounded once to 1 decimal, halves up; the bands read the rounded value."
  ],
  "inputs": {
    "$schema": "https://json-schema.org/draft/2020-12/schema",
    "type": "object",
    "properties": {
      "sys": {
        "title": "Systolic, top number (mmHg)",
        "description": "The systolic blood pressure, 50 to 300 mmHg.",
        "type": "number",
        "minimum": 50,
        "maximum": 300
      },
      "dia": {
        "title": "Diastolic, bottom number (mmHg)",
        "description": "The diastolic blood pressure, 20 to 200 mmHg.",
        "type": "number",
        "minimum": 20,
        "maximum": 200
      }
    }
  },
  "outputs": {
    "pp": {
      "label": "Pulse pressure (mmHg)",
      "description": "Systolic minus diastolic pressure, to 1 decimal.",
      "format": "number"
    },
    "ppp": {
      "label": "Proportional pulse pressure",
      "description": "Pulse pressure ÷ systolic pressure, in percent, to 1 decimal.",
      "format": "percent"
    },
    "pppCutoff": {
      "label": "Against the 25% cut-off",
      "description": "Whether the proportional pulse pressure shown is under 25% or 25% or more (Stevenson and Perloff 1989).",
      "format": "text"
    }
  },
  "defaultAnswer": {
    "inputs": {
      "sys": 120,
      "dia": 80
    },
    "outputs": {
      "pp": 40,
      "ppp": 33.3,
      "pppCutoff": "25% or more"
    },
    "text": "A blood pressure of 120/80 mmHg gives a pulse pressure of 40 mmHg, 33.3% of the systolic pressure."
  },
  "examples": [
    {
      "given": {
        "sys": 120,
        "dia": 80
      },
      "expect": {
        "pp": 40,
        "ppp": 33.3,
        "pppCutoff": "25% or more"
      },
      "source": "StatPearls, Physiology, Pulse Pressure: 120 − 80 is about 40 mmHg; 40 ÷ 120 = 33.33% (hand calculation in content.mdx)"
    },
    {
      "given": {
        "sys": 160,
        "dia": 90
      },
      "expect": {
        "pp": 70,
        "ppp": 43.8,
        "pppCutoff": "25% or more"
      },
      "source": "2023 ESH guidelines, PP = SBP − DBP: 160 − 90 = 70 mmHg, 60 mmHg or more (hand calculation in content.mdx)"
    },
    {
      "given": {
        "sys": 140,
        "dia": 80
      },
      "expect": {
        "pp": 60,
        "ppp": 42.9,
        "pppCutoff": "25% or more"
      },
      "source": "Band edge: 140 − 80 = 60 mmHg is in the 60 mmHg or more band (ESH 2023, Table 11) (hand calculation)"
    },
    {
      "given": {
        "sys": 100,
        "dia": 80
      },
      "expect": {
        "pp": 20,
        "ppp": 20,
        "pppCutoff": "Under 25%"
      },
      "source": "Stevenson and Perloff 1989: proportional pulse pressure 20 ÷ 100 = 20%, under 25% (hand calculation in content.mdx)"
    },
    {
      "given": {
        "sys": 120,
        "dia": 90
      },
      "expect": {
        "pp": 30,
        "ppp": 25,
        "pppCutoff": "25% or more"
      },
      "source": "Band edge: 30 ÷ 120 = 25.0%, in the 25% or more band (hand calculation in content.mdx)"
    },
    {
      "given": {
        "sys": 200,
        "dia": 150.1
      },
      "expect": {
        "pp": 49.9,
        "ppp": 25,
        "pppCutoff": "25% or more"
      },
      "source": "Rounded once to 1 decimal, halves up, then compared with 25% (hand calculation in content.mdx)"
    }
  ],
  "sources": [
    "Mancia G, Kreutz R, Brunström M, et al. 2023 ESH Guidelines for the management of arterial hypertension. J Hypertens. 2023;41(12):1874-2071 (section 3.3 and 3.4; Table 2, Factors that influence CV risk; Table 11, Criteria to define HMOD: brachial pulse pressure ≥60 mmHg over age 60; section on isolated systolic hypertension in the young). https://doi.org/10.1097/HJH.0000000000003480 (retrieved 2026-10-18)",
    "Stevenson LW, Perloff JK. The limited reliability of physical signs for estimating hemodynamics in chronic heart failure. JAMA. 1989;261(6):884-888 (abstract: proportional pulse pressure under 25%, 91% sensitivity and 83% specificity for a cardiac index under 2.2 L/min/m², 50 patients). https://doi.org/10.1001/jama.1989.03420060100040 (abstract: https://pubmed.ncbi.nlm.nih.gov/2913385/, retrieved 2026-10-18)",
    "Kothai G, Janani A, Malathy AR, Suthakaran PK. Evaluation of pulse pressure and proportional pulse pressure as predictors of severity among patients having heart failure with reduced ejection fraction. Ann Afr Med. 2020;19(3):188-190 (proportional pulse pressure = pulse pressure ÷ systolic pressure, in percent). https://pmc.ncbi.nlm.nih.gov/articles/PMC7694704/ (retrieved 2026-10-18)",
    "Homan TD, Bordes SJ, Cichowski E. Physiology, Pulse Pressure. StatPearls, last update July 10, 2023 (pulse pressure = systolic − diastolic; about 40 mmHg at 120/80; under 25% of systolic is narrowed). https://www.ncbi.nlm.nih.gov/books/NBK482408/ (retrieved 2026-10-18)"
  ],
  "related": [
    "mean-arterial-pressure",
    "blood-pressure"
  ],
  "changelog": [
    {
      "date": "2026-10-19",
      "note": "Published after this site's editorial review against the cited sources (no clinician review); the page notices say so."
    }
  ]
}