- With Mayo Clinic emeritus hypertension specialist
Sheldon G. Sheps, M.D.
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Sheldon G. Sheps, M.D.
Sheldon G. Sheps, M.D.
Dr. Sheldon Sheps, emeritus professor of medicine and former chair of the Hypertension Division in the Department of Medicine at Mayo Clinic, has been with Mayo Clinic since 1960.
Dr. Sheps, a Winnipeg, Manitoba, native, is board certified in internal medicine and specializes in hypertension and peripheral vascular diseases. He developed a multidisciplinary approach with specially trained nurses, dietitians, technicians and educators to help form a team approach to the treatment of patients with abnormal blood pressure.
"I have always believed in involving the patient and family in their health care," he says. "I have asked for their understanding of the illness and issues and for participation in decisions. The Web is a natural extension of that, and now many more people can be informed."
Dr. Sheps chaired the sixth working group, and participated in the fourth, fifth and seventh groups, that developed the then-latest guidelines for hypertension under the auspices of the National Heart, Lung and Blood Institute (NHLBI). He helped write the latest American Heart Association (AHA) report on blood pressure measurement. He chaired an AHA group that produced an online accreditation for blood pressure measurement for health professionals. He has co-authored books, newsletters, CD-ROMs and other Mayo Clinic health information material and joined Mayo Clinic's Web team in 1998. He was medical editor-in-chief of both editions of the "Mayo Clinic on High Blood Pressure" book; the last edition was published in 2003. He was also medical editor-in-chief of "Mayo Clinic 5 Steps to Controlling High Blood Pressure,'' published in 2008.
He was section editor for each of the first three editions of "Hypertension Primer" for the American Heart Association.
Dr. Sheps was also chairman of the Science Base Subcommittee, National High Blood Pressure Education Program, and was a consultant to the Hypertension Initiative of the World Health Organization. In 1997, he was honored with the Individual Achievement Award on the 25th anniversary of the National High Blood Pressure Education Program of NHLBI. In 2009, he was honored as a Distinguished Mayo Alumnus.
Definition (3)
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- Isolated systolic hypertension: A health concern?
- Blood pressure: Is it affected by weather?
Risk factors (2)
- Menopause and high blood pressure: What's the connection?
- Alcohol: Does it affect blood pressure?
Symptoms (1)
- Pulse pressure: An indicator of heart health?
Causes (5)
- Caffeine: How does it affect blood pressure?
- Anxiety: A cause of high blood pressure?
- Blood pressure readings: Why higher at home?
- see all in Causes
Complications (1)
- Hypertensive crisis: What are the symptoms?
Treatments and drugs (5)
- Calcium supplements: Do they interfere with blood pressure drugs?
- Blood pressure medications: Can they raise my triglycerides?
- Diuretics: A cause of low potassium?
- see all in Treatments and drugs
Lifestyle and home remedies (9)
- Resperate: Can it help reduce blood pressure?
- Blood pressure medication: Still necessary if I lose weight?
- High blood pressure and cold remedies: Which are safe?
- see all in Lifestyle and home remedies
Alternative medicine (1)
- L-arginine: Does it lower blood pressure?
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Question
Pulse pressure: An indicator of heart health?
What's the significance of the spread between systolic and diastolic blood pressure readings?
Answer
from Sheldon G. Sheps, M.D.
Blood pressure readings are given in two numbers. The top number is the maximum pressure your heart exerts while beating (systolic pressure), and the bottom number is the amount of pressure in your arteries between beats (diastolic pressure). The numeric difference between your systolic and diastolic blood pressure is called your pulse pressure. For example, if your resting blood pressure is 120/80 millimeters of mercury (mm Hg), your pulse pressure is 40 — the difference between 120 and 80.
Research suggests that an elevated pulse pressure may be a strong predictor of heart problems, especially for older adults. Generally, a pulse pressure greater than 60 mm Hg is abnormal.
The most important cause of elevated pulse pressure is stiffness and reduced elasticity of the aorta, the largest artery in the body. This may be due to high blood pressure or fatty deposits on the walls of the arteries (atherosclerosis). The greater your pulse pressure, the stiffer and more damaged the vessels are thought to be. Other conditions — including severe anemia and overactive thyroid (hyperthyroidism) — can increase pulse pressure as well.
Treating high blood pressure usually reduces pulse pressure as well.
Next questionCaffeine: How does it affect blood pressure?
- Assmann G, et al. Importance of arterial pulse pressure as a predictor of coronary heart disease risk in PROCAM. European Heart Journal. 2005;26:2120.
- Townsend RR. Increased pulse pressure. http://www.uptodate.com/home/index.html. Accessed Sept. 17, 2008.
- Inaba M, et al. Increased stiffness in common carotid artery in hyperthyroid Graves' disease patients. Biomedicine and Pharmacotherapy. 2002;56:241.
- O'Meara E, et al. Clinical correlates and consequences of anemia in a broad spectrum of patients with heart failure. Circulation. 2006;113:986.
- de Simone G, et al. Is high pulse pressure a marker of preclinical cardiovascular disease? Hypertension. 2005;45:575.
