Editing Pulse pressure (section)

==== Consistently high ====
A pulse pressure of 50&nbsp;mmHg or more can increase the risk of heart disease, heart rhythm disorders, stroke and other cardiovascular diseases and events. Higher pulse pressures are also thought to play a role in eye and kidney damage from diseases such as diabetes.<ref name="Cleveland Clinic 2021"/> There are currently no drugs approved to lower pulse pressure, but some [[antihypertensive drug]]s have been shown to modestly lower pulse pressure, while other drugs used for [[hypertension]] can actually have the counterproductive side effect of increasing resting pulse pressure.<ref name="cushman" />

The aorta has the highest compliance in the arterial system due in part to a relatively greater proportion of [[Elastic fiber|elastin fibers]] versus [[smooth muscle]] and [[collagen]]. This serves to dampen the pulsatile [[ejection fraction]] of the [[left ventricle]], thereby reducing the initial systolic pulse pressure, but slightly raising the subsequent diastolic phase. If the aorta becomes rigid, stiff and inextensible because of disorders, such as [[arteriosclerosis]], [[atherosclerosis]] or [[Connective tissue disease|elastin defects]] (in connective tissue diseases), the pulse pressure would be higher due to less compliance of the aorta.<ref>See also: [[Central aortic blood pressure]]</ref>

In hypertensive patients, a high pulse pressure can often be an indicator of [[conduit artery]] stiffness ([[Arterial stiffness|stiffness of the major arteries]]).<ref name="Mitchell Izzo Lacourcière Ouellet 2002 pp. 2955–2961"/> When the arterial walls are stiffer (less compliant), the heart has to beat harder to overcome the resistance from the stiff arteries, resulting in an increased pulse pressure.<ref name="News-Medical.net 2009 f388">{{cite web | title=What is Arterial Stiffness? | website=News-Medical.net | date=23 Nov 2009 | url=https://www.news-medical.net/health/What-is-Arterial-Stiffness.aspx | access-date=18 Nov 2023}}</ref>

Other conditions that can lead to a high pulse pressure include [[aortic regurgitation]],<ref name=Tang2020/> [[aortic sclerosis]], severe [[iron-deficiency anemia]] (due to decreased [[blood viscosity]]), [[arteriosclerosis]] (due to loss of arterial compliance), and [[hyperthyroidism]]<ref name=Tang2020/> (due to increased systolic pressure), or [[arteriovenous malformation]], among others.<ref name=":0" /> In aortic regurgitation, the aortic valve insufficiency results in the backward flow of blood (regurgitation) that is ejected during systole, and its return to the left ventricle during diastole. This increases the systolic blood pressure, and decreases the diastolic blood pressure, leading to a widened pulse pressure.<ref name=":0" /><ref name="Cleveland Clinic 2021" />

A high pulse pressure combined with [[bradycardia]] and an irregular breathing pattern is associated with increased [[intracranial pressure]], a condition called [[Cushing's triad]] seen in people after head trauma with increased intracranial pressure.<ref name="cushing">{{cite book |  vauthors = Dinallo S, Waseem M | chapter-url=https://www.ncbi.nlm.nih.gov/books/NBK549801/ | pmid=31747208 | year=2022  | chapter = Cushing reflex | title = StatPearls | location = Treasure Island (FL) | publisher = StatPearls Publishing }}</ref>

Common causes of widening pulse pressure include:<ref name="Cleveland Clinic 2021"/>
* [[Anemia]]
* [[Aortic dissection]]
* [[Atherosclerosis]]<ref name="Tang2020">{{cite journal |last1=Tang |first1=KS |last2=Medeiros |first2=ED |last3=Shah |first3=AD |title=Wide pulse pressure: A clinical review. |journal=Journal of Clinical Hypertension (Greenwich, Conn.) |date=November 2020 |volume=22 |issue=11 |pages=1960–1967 |doi=10.1111/jch.14051 |pmid=32986936 |pmc=8029839 }}</ref>
* [[Arteriovenous fistula]]<ref name=Tang2020/>
* [[Aortic regurgitation|Chronic aortic regurgitation]]
* [[Aortic aneurysm|Aortic root aneurysm]]<ref name="Dilation of the thoracic aorta: med">{{cite journal | vauthors = Nataf P, Lansac E | title = Dilation of the thoracic aorta: medical and surgical management | journal = Heart | volume = 92 | issue = 9 | pages = 1345–1352 | date = September 2006 | pmid = 16908722 | pmc = 1861150 | doi = 10.1136/hrt.2005.074781 }}</ref>
* Aortic root dilation<ref name="Dilation of the thoracic aorta: med"/>
* [[Beri beri]]<ref name=Tang2020/>
* [[Distributive shock]]<ref name=Tang2020/>
* [[Endocarditis]]
* [[Fever]]
* [[Heart block]]
* [[intracranial pressure|Increased intracranial pressure]]<ref name=cushing/><ref name=Tang2020/>
* [[Patent ductus arteriosus]]
* [[Pregnancy]]<ref name=Tang2020/>
* [[Thyrotoxicosis]]<ref name=Tang2020/>