WordNet

drive by or as if by pulsation; "A soft breeze pulsed the air"
the rate at which the heart beats; usually measured to obtain a quick evaluation of a persons health (同)pulse_rate, heart_rate
the rhythmic contraction and expansion of the arteries with each beat of the heart; "he could feel the beat of her heart" (同)pulsation, heartbeat, beat
edible seeds of various pod-bearing plants (peas or beans or lentils etc.)
produce or modulate (as electromagnetic waves) in the form of short bursts or pulses or cause an apparatus to produce pulses; "pulse waves"; "a transmitter pulsed by an electronic tube" (同)pulsate
the force applied to a unit area of surface; measured in pascals (SI unit) or in dynes (cgs unit); "the compressed gas exerts an increased pressure" (同)pressure level, force per unit area
an oppressive condition of physical or mental or social or economic distress
the somatic sensation that results from applying force to an area of skin; "the sensitivity of his skin to pressure and temperature was normal" (同)pressure_sensation
a force that compels; "the public brought pressure to bear on the government"
100 puls equal 1 afghani in Afghanistan

PrepTutorEJDIC

《通例単数形で》『脈はく』 / (一般に,規則的な)鼓動,律動 / (電気の)パルス / (一般的な)傾向 / 脈を打つ,鼓動する
〈U〉《時に複数扱い》(食用の)豆類 / 〈C〉《通例複数形で》豆のとれる植物
〈U〉『押すこと』,『押しつけること』,圧搾,圧縮;〈C〉〈U〉『圧力』,圧力の強さ / 〈U〉『圧迫』,『強制』 / 〈U〉(不快な)圧迫感 / 〈C〉〈U〉(精神的な)重荷,苦脳;(時間・金銭的)切迫 / 〈U〉多忙,あわただしさ / 《おもに米》…‘に'圧力をかける,強制する(《英》pressurise)

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2014/04/07 17:43:45」(JST)

wiki en

Pulse pressure is the difference between the systolic and diastolic pressure readings. It is measured in millimeters of mercury (mmHg). It represents the force that the heart generates each time it contracts. If resting blood pressure is (systolic/diastolic) 120/80 millimeters of mercury (mmHg), pulse pressure is 40.^[1]

1 Calculation
2 Values and variation
- 2.1 Low (Narrow) Pulse Pressure
- 2.2 High (Wide) Pulse Pressure
  - 2.2.1 High values during or shortly after exercise
  - 2.2.2 Consistently high values
3 Relationship to heart disease
4 Self measurement
5 Treatment
- 5.1 Effect of folic acid
6 See also
7 References

Calculation

Formally it is the systolic pressure minus the diastolic pressure.^[2]

Theoretically, the systemic pulse pressure can be conceptualized as being proportional to stroke volume, or the amount of blood ejected from the left ventricle during systole and inversely proportional to the compliance of the aorta.^[3]

The aorta has the highest compliance in the arterial system due in part to a relatively greater proportion of elastin fibers versus smooth muscle and collagen. This serves the important function of damping the pulsatile output of the left ventricle, thereby reducing the pulse pressure. If the aorta becomes rigid in conditions such as arteriosclerosis or atherosclerosis, the pulse pressure would be very high.

Systemic pulse pressure = P_systolic - P_diastolic = 120mmHg - 80mmHg = 40mmHg
Pulmonary pulse pressure = P_systolic - P_diastolic = 25mmHg - 10mmHg = 15mmHg

Values and variation

Low (Narrow) Pulse Pressure

A pulse pressure is considered abnormally low if it is less than 25% of the systolic value. The most common cause of a low (narrow) pulse pressure is a drop in left ventricular stroke volume. In trauma a low or narrow pulse pressure suggests significant blood loss (insufficient preload leading to reduced cardiac output).^[4]

If the pulse pressure is extremely low, i.e. 25 mmHg or less, the cause may be low stroke volume, as in Congestive Heart Failure and/or shock.

A narrow pulse pressure is also caused by aortic valve stenosis and cardiac tamponade.

High (Wide) Pulse Pressure

High values during or shortly after exercise

Usually, the resting pulse pressure in healthy adults, sitting position, is about 30-40 mmHg. The pulse pressure increases with exercise due to increased stroke volume,^[5] healthy values being up to pulse pressures of about 100 mmHg, simultaneously as total peripheral resistance drops during exercise. In healthy individuals the pulse pressure will typically return to normal within about 10 minutes.

For most individuals, during aerobic exercise, the systolic pressure progressively increases while the diastolic remains about the same. In some very aerobically athletic individuals, for example distance runners, the diastolic will progressively fall as the systolic increases. This behavior facilitates a much greater increase in stroke volume and cardiac output at a lower mean arterial pressure and enables much greater aerobic capacity and physical performance. The diastolic drop reflects a much greater fall in total peripheral resistance of the muscle arterioles in response to the exercise (a greater proportion of red versus white muscle tissue). Individuals with larger BMIs due to increased muscle mass (body builders) have also been shown to have lower diastolic pressures and larger pulse pressures.^[6]

Consistently high values

If the usual resting pulse pressure is consistently greater than 100 mmHg, the most likely basis is stiffness of the major arteries, aortic regurgitation (a leak in the aortic valve), arteriovenous malformation (an extra path for blood to travel from a high pressure artery to a low pressure vein without the gradient of a capillary bed), hyperthyroidism or some combination. (A chronically increased stroke volume is also a technical possibility, but very rare in practice.) While some drugs for hypertension have the side effect of increasing resting pulse pressure irreversibly, other hypertension drugs, such as ACE Inhibitors, have been shown to lower pulse pressure. A high resting pulse pressure is harmful and tends to accelerate the normal aging of body organs, particularly the heart, the brain and kidneys. A high pulse pressure combined with bradycardia and an irregular breathing pattern is associated with increased intracranial pressure and should be reported to a physician immediately. This is known as Cushing's triad and can be seen in patients after head trauma related to intracranial hemorrhage or edema.

Examples: (these are examples of WIDENING pulse pressure causes)

Atherosclerosis
Arteriovenous fistula
Chronic aortic regurgitation
Thyrotoxicosis
Fever
Anemia
Pregnancy
Anxiety
Heart block
Aortic dissection
Endocarditis
Raised intracranial pressure
beri beri
hyperkinetic heart syndrome

Relationship to heart disease

Recent work suggests that a high pulse pressure is an important risk factor for heart disease. A meta-analysis in 2000, which combined the results of several studies of 8,000 elderly patients in all, found that a 10 mm Hg increase in pulse pressure increased the risk of major cardiovascular complications and mortality by nearly 20%.^[7] Heightened pulse pressure is also a risk factor for the development of atrial fibrillation.^[8] The authors of the meta-analysis suggest that this helps to explain the apparent increase in risk sometimes associated with low diastolic pressure, and warn that some medications for high blood pressure may actually increase the pulse pressure and the risk of heart disease.

Self measurement

Pulse pressure readings can be taken on a home blood pressure monitoring device. These devices display systolic and diastolic blood pressure, from which pulse pressure can be calculated, and pulse rate readings. Monitoring at home will measure true pulse and blood pressure and is helpful to a medical provider in interpreting in-office results and/or progression of disease processes.

Treatment

If the patient suffers from elevated pulse pressure, treatment may include medications that address this factor, such as an angiotensin-converting enzyme inhibitor (ACE inhibitor).^[9]

Effect of folic acid

A 2005 study found that 5 mg of folate daily over a three-week period reduced pulse pressure by 4.7 mm of Hg compared with a placebo, and concluded that folic acid is an effective supplement that targets large artery stiffness and may prevent isolated systolic hypertension.^[10]

References

^ A review of educational strategies to improve nurses' roles in recognizing and responding to deteriorating patients. Liaw SY, Scherpbier A, Klainin-Yobas P, Rethans JJ.
^ http://highbloodpressure.about.com/od/highbloodpressure101/p/pulse_pressure.htm
^ Arterial pulse pressure
^ American College of Surgeons (2008). Atls, Advanced Trauma Life Support Program for Doctors. Amer College of Surgeons. p. 58. ISBN [[Special:BookSources/1-880696-31-6|1-880696-31-6 [[Category:Articles with invalid ISBNs]]]] Check |isbn= value (help).
^ DETERMINATION OF CARDIAC OUTPUT IN MEDICAL STUDENTS BY PULSE PRESSURE METHOD, Farida Munawar, Fareeha, Maryam, Sana, Anushe, Nida - Department of Physiology, Fatima Jinnah Medical College, Lahore, Pak J Physiol 2007;3(2)
^ Muscular Strength Training Is Associated With Low Arterial Compliance and High Pulse Pressure -- Bertovic et al. 33 (6): 1385 -- Hypertension
^ Blacher J, Staessen JA, Girerd X, Gasowski J, Thijs L, Liu L, Wang JG, Fagard RH, Safar ME. Pulse pressure not mean pressure determines cardiovascular risk in older hypertensive patients. Arch Intern Med 2000 Apr 24;160(8):1085-9. PMID 10789600
^ Pulse Pressure Important Risk Factor for the Development of New-Onset AF CME^{[dead link]}
^ Pulse Pressure Builds Steam as Mortality Predictor - Brief Article - Statistical Data Included http://findarticles.com/p/articles/mi_m0BJI/is_1_30/ai_59457655

hypertensive patients with high pulse pressures should include a drug that is effective at reducing pulse pressure, and angiotensin-converting enzyme inhibitors are the best for this purpose.
^ Carolyn Williams, Bronwyn A Kingwell, Kevin Burke, Jane McPherson and Anthony M Dart: Folic acid supplementation for 3 wk reduces pulse pressure and large artery stiffness independent of MTHFR genotype. American Journal of Clinical Nutrition, Vol. 82, No. 1, 26-31, July 2005 http://www.ajcn.org/cgi/content/full/82/1/26

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

1. 脈圧の上昇 increased pulse pressure
2. 動脈拍動の検討 examination of the arterial pulse
3. 胸部大動脈瘤の疫学、危険因子、病因、および自然史 epidemiology risk factors pathogenesis and natural history of thoracic aortic aneurysm
4. 高血圧：誰が治療が必要か？ hypertension who should be treated
5. 総動脈幹 truncus arteriosus

English Journal

Angiotensin-(1-7) decreases LPS-induced inflammatory response in macrophages.

Souza LL, Costa-Neto CM.SourceDepartment of Biochemistry and Immunology, Faculty of Medicine at Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
Journal of cellular physiology.J Cell Physiol.2012 May;227(5):2117-22. doi: 10.1002/jcp.22940.
It has been previously shown that besides its classical role in blood pressure control the renin-angiotensin system, mainly by action of angiotensin II on the AT(1) receptor, exerts pro-inflammatory effects such as by inducing the production of cytokines. More recently, alternative pathways to this
PMID 21769868

Spectroscopic and thermodynamic features of conical bubble luminescence.

Godínez FA, Navarrete M, Sánchez-Ake C, Mejía-Uriarte EV, Villagrán-Muniz M.SourceInstituto de Ingeniería, Universidad Nacional Autónoma de México, Av. Universidad 3000, Universidad Nacional Autónoma de México, C. U. Distrito Federal, 04510 México, Mexico.
Ultrasonics sonochemistry.Ultrason Sonochem.2012 May;19(3):668-81. Epub 2011 Sep 10.
The influence on luminescence from conical bubble collapse (CBL) with varying Ar gas content while perturbing the liquid 1,2-Propanediol (PD) has been investigated. The temporal, spatial, and spectral features were analysed with regards to the dynamics of collapse and liquid degradation. Sulphuric a
PMID 21963140

Effect of short- and long-term portal hypertension on adrenergic, nitrergic and sensory functioning in rat mesenteric artery.

Sastre E, Balfagón G, Revuelta-López E, Aller MÁ, Nava MP, Arias J, Blanco-Rivero J.SourceDepartamento de Fisiología, Facultad de Medicina, Universidad Autónoma de Madrid, Madrid, Spain.
Clinical science (London, England : 1979).Clin Sci (Lond).2012 Apr;122(7):337-48.
In the present study, we analysed possible alterations in adrenergic, nitrergic and sensory functioning in mesenteric arteries from rats at 1 and 21 months after partial portal vein ligation, and the mechanisms involved in these alterations, if any. For this purpose, we analysed the vasoconstrictor
PMID 21999248

Japanese Journal

Thermal and shock induced modification inside a silica glass by focused femtosecond laser pulse

Sakakura Masaaki,Terazima Masahide,Shimotsuma Yasuhiko,Miura Kiyotaka,Hirao Kazuyuki
Journal of Applied Physics 109(2), 2011-01
… The femtosecond laser induced structural modification was studied by the detection of a laser induced pressure wave using a transient lens (TrL) method. … The TrL signals observed at various excitation pulse energies showed that there were two thresholds of the pulse energy for the modification. …
NAID 120002871153

Effects of pressure on the optical emissions observed from solids immersed in water using a single pulse laser

Thornton Blair,Ura Tamaki
Applied physics express 4(2), 022702-1-3, 2011-02
NAID 40018283087

Related Pictures

Pulse Pressure - The Definitive Guide | Biology Dictionary Pulse pressure definition, wide pulse pressure & narrow pulse pressure Pulse Pressure (Wide, Narrow & Normal) + How to Calculate - SelfHacked PPT - Cardiac Output, Blood Flow, and Blood Pressure PowerPoint Presentation - ID:312723 Pulse pressure is important as it is often overlooked… | Cardiac Cardiology: Pulse Pressure Widened Pulse Pressure - Differential Diagnosis and | GrepMed 20.2 Blood Flow, Blood Pressure, and Resistance – Anatomy and Physiology