Pulse Pressure and Mean Arterial Pressure

Hypertension Exercise Program

Best Home Remedy for Hypertension

Get Instant Access

When someone "takes a pulse," he or she palpates an artery (for example, the radial artery) and feels the expansion of the artery occur in response to the beating of the heart; the pulse rate is thus a measure of the cardiac rate. The expansion of the artery with each pulse occurs as a result of the rise in blood pressure within the artery as the artery receives the volume of blood ejected by a stroke of the left ventricle.

Since the pulse is produced by the rise in pressure from dia-stolic to systolic levels, the difference between these two pressures is known as the pulse pressure. A person with a blood pressure of 120/80 (systolic/diastolic) would therefore have a pulse pressure of 40 mmHg.

Pulse pressure = systolic pressure - diastolic pressure

Korotkoff Sounds

No sounds

Cuff pressure = 140

Korotkoff Sounds

First Korotkoff sounds

Cuff pressure = 120

Systolic pressure = 120 mmHg

Korotkoff Sounds

Sounds at every systole

Cuff pressure = 100

Korotkoff Sounds Images

Last Korotkoff sounds

Cuff pressure = 80

Diastolic pressure = 80 mmHg

Blood pressure = 120/80

■ Figure 14.29 The blood flow and Korotkoff sounds during a blood pressure measurement. When the cuff pressure is above the systolic pressure, the artery is constricted. When the cuff pressure is below the diastolic pressure, the artery is open and flow is laminar. When the cuff pressure is between the diastolic and systolic pressure, blood flow is turbulent and the Korotkoff sounds are heard with each systole.

Cuff pressure

No flow

Turbulent flow

Laminar flow

Systole

Blood pressure

Diastole

Korotkoff Sounds

■ Figure 14.30 The indirect, or auscultatory, method of blood pressure measurement. The first Korotkoff sound is heard when the cuff pressure is equal to the systolic blood pressure, and the last sound is heard when the cuff pressure is equal to the diastolic pressure. The dashed line indicates the cuff pressure.

Cardiac Output, Blood Flow, and Blood Pressure

130 120 110 100

Blood flows during systole only (turbulent flow)

14 mmHg

20 mmHg

Snapping sounds

Murmurs

Relative intensity of sounds

t ol led

5 mmHg

5 mmHg

■ Figure 14.31 The five phases of blood pressure measurement.

Not all phases are heard in all people. The cuff pressure is indicated by the falling dashed line.

At diastole in this example, the aortic pressure equals 80 mmHg. When the left ventricle contracts, the intraventricular pressure rises above 80 mmHg and ejection begins. As a result, the amount of blood in the aorta increases by the amount ejected from the left ventricle (the stroke volume). Due to the increase in volume, there is an increase in blood pressure. The pressure in the brachial artery, where blood pressure measurements are commonly taken, therefore increases to 120 mmHg in this example. The rise in pressure from diastolic to systolic levels (pulse pressure) is thus a reflection of the stroke volume.

Clinical Investigation Clue

Remember that Charlie's pulse was weak.

What is the sequence of effects that caused Charlie's pulse to be weak?

The mean arterial pressure represents the average arterial pressure during the cardiac cycle. This value is significant because it is the difference between this pressure and the venous pressure that drives blood through the capillary beds of organs. The mean arterial pressure is not a simple arithmetic average because the pe riod of diastole is longer than the period of systole. Mean arterial pressure can be approximated by adding one-third of the pulse pressure to the diastolic pressure. For a person with a blood pressure of 120/80, for example, the mean arterial pressure would be approximately 80 + 1/3 (40) = 93 mmHg.

Mean arterial pressure = diastolic pressure + 1/3 pulse pressure

A rise in total peripheral resistance and cardiac rate increases the diastolic pressure more than it increases the systolic pressure. When the baroreceptor reflex is activated by going from a lying to a standing position, for example, the diastolic pressure usually increases by 5 to 10 mmHg, whereas the systolic pressure either remains unchanged or is slightly reduced (as a result of decreased venous return). People with hypertension (high blood pressure), who usually have elevated total peripheral resistance and cardiac rates, likewise have a greater increase in diastolic than in systolic pressure. Dehydration or blood loss results in decreased cardiac output, and thus also produces a decrease in pulse pressure.

An increase in cardiac output, by contrast, raises the systolic pressure more than it raises the diastolic pressure (although both pressures do rise). This occurs during exercise, for example, when the blood pressure may rise to values as high as 200/100 (yielding a pulse pressure of 100 mmHg).

Test Yourself Before You Continue

1. Describe the relationship between blood pressure and the total cross-sectional area of arteries, arterioles, and capillaries. Describe how arterioles influence blood flow through capillaries and arterial blood pressure.

Explain how the baroreceptor reflex helps to compensate for a fall in blood pressure. Why will a person who is severely dehydrated have a rapid pulse?

Describe how the sounds of Korotkoff are produced and explain how these sounds are used to measure blood pressure. Define pulse pressure and explain the physiological significance of this measurement.

Was this article helpful?

0 0
Reducing Blood Pressure Naturally

Reducing Blood Pressure Naturally

Do You Suffer From High Blood Pressure? Do You Feel Like This Silent Killer Might Be Stalking You? Have you been diagnosed or pre-hypertension and hypertension? Then JOIN THE CROWD Nearly 1 in 3 adults in the United States suffer from High Blood Pressure and only 1 in 3 adults are actually aware that they have it.

Get My Free Ebook


Responses

  • makda
    What is the stroke volume of someone with a blood pressure of 120/80?
    8 years ago
  • verdiana palermo
    Why is mean arterial pressure not equal to the arithmetic mean of the?
    8 years ago
  • DANIEL AMANUEL
    Why will a person severely dehydrated have rapid pulse?
    8 years ago
  • basso
    What is mean arterial pressure/pulse pressure physiology ?
    8 years ago
  • Mikki
    What is the difference between pulse pressure and mean arterial pressure?
    8 years ago
  • Kenzie
    What would the pulse pressure and mean arterial pressure be for an individual with a bp of 120/80?
    8 years ago
  • Alison
    What is the human mean arterial pressure?
    8 years ago
  • Eemeli
    Why is mean arterial pressure not equal to systolic pressure diastolic pressure 2?
    8 years ago
  • katharina
    Why is the first korotokoff sound heard when the cuff pressure equals the systolic pressure?
    8 years ago
  • ronald
    What is the difference between arterial blood pressure, pulse pressure, and mean arterial pressure?
    8 years ago
  • cristian
    Is stroke volume equal to pulse pressure?
    8 years ago
  • jan-erik
    Why does the first sound heard in cuff equa systolic pressure?
    8 years ago
  • ines
    Why one third of pulse pressure is used in measuring mean pressure?
    3 years ago
  • Isengrin
    Why 1/3 of pulse pressue is taken?
    3 years ago
  • Eugenia
    Why pulse pressur is one third of diastolic prassure?
    2 years ago
  • Brent
    How to calculate for arterial pressure and pulse pressure using systolic and di.astolic preau?
    2 years ago
  • michael
    Why do we use 1/3 of pulse pressire in measuring nlood pressure?
    2 years ago
  • fiore
    Why mean blood press is not arithmetic?
    1 year ago
  • senay aatifa
    Is mean arterial pressure increase by increasing pulse pressure?
    1 year ago
  • rufina
    How do venous pressures differ from arterial presir?
    7 months ago
  • gandolfo ricci
    What is more significant pulse pressure or mean arterial pressure?
    6 months ago
  • Rohan
    What is cuff pressure physiology?
    6 months ago
  • Tanta
    What is the relationship between pulse pressure and mean arterial pressure?
    2 months ago
  • troy
    How does map differ from pulse pressure?
    8 days ago

Post a comment