Most people focus on the top and bottom blood pressure numbers. The gap between them, called pulse pressure, carries its own information, and it is one of the few blood pressure measures that changes character as you age.
Quick answer: Pulse pressure is systolic minus diastolic. A reading of 120/80 has a pulse pressure of 40, which is typical. Pulse pressures that are consistently 60 or higher are often called wide, and in older adults a wide pulse pressure is associated with stiffer arteries and higher cardiovascular risk. A very narrow pulse pressure can also be a reason to ask questions. It is a prompt for a conversation, not a diagnosis.
How to calculate it
Subtract the bottom number from the top. For 130/80, the pulse pressure is 50. For 150/70, it is 80. Use your average rather than one reading; the blood pressure average calculator and our guide to calculating average blood pressure show how. Average the systolic values and the diastolic values first, then subtract. Subtracting each reading and then averaging gives the same answer, but starting from the averages is easier to check.
Examples at a glance
The table below shows how different readings produce different pulse pressures. The last column is mean arterial pressure (diastolic plus one third of pulse pressure), a hospital measure shown here for context.
| Reading | Pulse pressure | Pulse pressure as % of systolic | Mean arterial pressure | What stands out |
|---|---|---|---|---|
| 120/80 | 40 | 33% | 93 | Typical gap |
| 130/80 | 50 | 38% | 97 | Systolic higher, diastolic same |
| 138/76 | 62 | 45% | 97 | Wide gap with a lower diastolic |
| 150/70 | 80 | 53% | 97 | Wide gap; common pattern in older adults |
| 160/70 | 90 | 56% | 100 | Very wide gap; discuss with a clinician |
| 100/80 | 20 | 20% | 87 | Narrow gap relative to systolic |
| 110/70 | 40 | 36% | 83 | Typical gap at a lower level |
Notice that 130/80, 138/76, and 150/70 all have nearly the same mean arterial pressure of about 97, yet very different pulse pressures. That is why pulse pressure adds information the average alone does not.
Why it widens
With age, large arteries lose elasticity. Stiffer arteries let systolic pressure climb while diastolic pressure stays flat or falls, so the gap grows. Other causes of a wide gap include some heart valve problems (such as a leaky aortic valve), an overactive thyroid, anemia, and fever. Only a clinician can sort out which applies.
Why it narrows
A pulse pressure that is small relative to the systolic number, often described as under about a quarter of it, can occur with reduced heart output, dehydration or blood loss, or certain heart conditions. A single narrow reading after a hard workout, illness, or standing up quickly is common; a persistent pattern with symptoms such as dizziness, fainting, or breathlessness is worth raising promptly.
What the Framingham data showed about age
The clearest research on how the meaning of the numbers shifts with age comes from the Framingham Heart Study. A 2001 analysis in Circulation by Franklin and colleagues followed participants for 20 years and found that the best single predictor of coronary heart disease risk changed with age: in people younger than 50, diastolic pressure was the strongest predictor; between 50 and 59, systolic, diastolic, and pulse pressure were comparable; and at 60 and older, pulse pressure was the strongest, with diastolic pressure inversely related once systolic was accounted for. The authors concluded that predictive value shifts from diastolic to systolic to pulse pressure as people age. You can read the paper through its DOI link.
That finding is the origin of the common rule of thumb that a wide pulse pressure matters more after about 60. It is population-level evidence, and it does not tell any individual what their number means.
What is and is not known
Large studies in middle-aged and older adults associate higher pulse pressure with cardiovascular events, particularly after age 50. What is less clear is whether treating pulse pressure itself, as opposed to treating overall blood pressure, changes outcomes. The MedlinePlus high blood pressure page is a general reference for the standard categories.
Pulse pressure sits next to the question of whether systolic or diastolic matters more. For the wider picture, including how blood pressure relates to insulin resistance, see our complete guide to blood pressure and blood pressure and insulin resistance. Do not change blood pressure medicine based on this number.
A worked example: a week of readings
A person logs a home average of 138 systolic and 76 diastolic across seven days. Pulse pressure = 138 – 76 = 62, which is on the wide side. Under U.S. office categories the systolic number alone places the reading in stage 1. That combination, a moderately high systolic with a lower diastolic, is common in people over 60 and is what the Framingham data describe. The reasonable next step is to bring the log to a clinician, who can check for causes and decide what, if anything, to do.
Pulse pressure in younger and fit people
Not every wide gap signals stiff arteries. In younger adults and well-trained athletes, a large stroke volume and a low resting diastolic pressure can produce a wide pulse pressure that reflects fitness rather than risk. A reading such as 124/64 has a gap of 60 and may be unremarkable in a fit 25-year-old, while the same gap at 165/105 is a different conversation. This is why age, fitness, symptoms, and the actual levels of the two numbers all matter when reading the gap, and why a clinician rather than a calculator should interpret an unusual pattern.
How to track pulse pressure at home
- Take readings the same way each time: seated and rested for five minutes, cuff at heart level, two readings a minute apart, morning and evening.
- Record every reading as systolic over diastolic. Do not record the gap alone.
- After seven days, average the systolic readings and the diastolic readings separately.
- Subtract the diastolic average from the systolic average to get your average pulse pressure.
- Compare the average with earlier weeks; the direction over months is more informative than any one week.
- Bring the log, not just the gap, to your clinician.
The seven-day blood pressure log gives a ready-made format, and how to measure blood pressure at home covers technique.
How the gap relates to the American Heart Association categories
The AHA categories use only systolic and diastolic values, not pulse pressure. The table below shows how readings with the same category can have very different gaps.
| Reading | AHA office category | Pulse pressure |
|---|---|---|
| 118/78 | Normal | 40 |
| 126/82 | Stage 1 (diastolic 80 to 89) | 44 |
| 134/78 | Stage 1 (systolic 130 to 139) | 56 |
| 152/76 | Stage 2 (systolic 140 or higher) | 76 |
| 142/88 | Stage 2 (systolic 140 or higher) | 54 |
Categories tell you where the readings sit against guideline thresholds; pulse pressure tells you about the shape of the pressure wave. Neither replaces the other.
Why arterial stiffness matters
Healthy large arteries stretch with each heartbeat and recoil afterward, buffering the pulse. When they stiffen, the buffer weakens: systolic pressure peaks higher and diastolic pressure falls faster. The change is gradual and shows up in the gap long before symptoms. Age, long-standing high blood pressure, diabetes, and smoking are all linked to stiffer arteries in the research. That is the logic behind watching pulse pressure over time, and it is also a reason the blood pressure and glucose numbers on this site belong together as a set.
Common mistakes
- Calculating pulse pressure from a single reading.
- Treating a wide gap as the only number that matters and ignoring the average.
- Mixing home and clinic readings in one average.
- Assuming a narrow gap is always good or always bad.
- Adjusting medicine because of a gap without asking the prescriber.
Questions to bring to your appointment
- Is my pulse pressure in a range you would watch?
- Could my arteries, thyroid, or heart valves be contributing?
- Does my average pulse pressure change which target you choose?
- Do I need any tests?
- How often should I log readings to track this?
Frequently asked questions
What is a normal pulse pressure?
A reading of 120/80 has a pulse pressure of 40, which is typical. There is no single official normal range, but researchers and clinicians often treat about 40 as typical, consistently 60 or higher as wide, and a gap smaller than about a quarter of the systolic number as narrow.
Why does my pulse pressure rise as I get older?
Large arteries lose elasticity with age. Stiffer arteries let systolic pressure climb while diastolic pressure stays flat or falls, so the gap widens. Framingham Heart Study analysis found that the best single predictor of coronary risk shifts from diastolic pressure in younger adults to pulse pressure in people 60 and older.
Is a high pulse pressure dangerous?
A wide pulse pressure is associated with higher cardiovascular risk in middle-aged and older adults in large studies, but one reading does not tell you much. It is a reason to check the average, look at the full picture, and talk to a clinician, not a reason to panic.
Is a low pulse pressure a problem?
Sometimes. A persistently narrow pulse pressure can occur with reduced heart output, certain valve or heart problems, or dehydration. A single narrow reading after exercise, illness, or standing quickly is common. If it persists, or comes with dizziness, fainting, or shortness of breath, tell a clinician.
What is mean arterial pressure?
Mean arterial pressure is a weighted average of pressure across the heartbeat, estimated as diastolic plus one third of pulse pressure. For 120/80 it is about 93. Clinicians use it in hospital settings; for home monitoring, systolic, diastolic, and pulse pressure are the numbers that matter.
Can I lower my pulse pressure?
Do not try to target it on its own. Pulse pressure usually moves with overall blood pressure and artery stiffness, and the approaches studied for blood pressure are discussed in our article on diet for high blood pressure. Ask your prescriber before changing any medicine.
Should I use one reading or an average?
An average. Pulse pressure from a single reading inherits all the noise of two numbers. Use at least a week of home readings and calculate the average systolic and diastolic first, then subtract.
About the author: Charles Kirkland is the founder of Metabolic Clarity Labs and author of The Journey Back. He is not a physician. This is general education, not a medically reviewed treatment plan.
Sources checked October 31, 2026. Discuss personal decisions with a qualified clinician. Do not start, stop, or change prescribed treatment based on this article.
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