Rate Pressure Product

This article describes rate pressure product as it is reported in the results of a Pulsewave reading. It also provides a summary of some key topics relating to rate pressure product, such as its classification.

abbrev

Introduction

The heart, a contractile organ within the circulatory system, pumps blood through the blood vessels by repeated rhythmic contractions. Being an aerobic organ, it consumes oxygen in proportion to its workload. Two of the factors which determine this are the blood pressure and the heart rate (HR).

According to guidelines released by the American Heart Association, the rate pressure product (RPP) estimates the myocardial oxygen consumption (and hence the stress on the heart) and is defined as the product of the brachial systolic blood pressure (SYS) and the HR. Under normal circumstances, the pulse rate (PR) coincides with the HR and the RPP can be calculated as the product of SYS and the PR. The RPP which is displayed as part of the Pulsewave results is the product of SYS, in units of mmHg, and the pulse rate average (PRA), in units of Hz – pulses per second. RPP is reported in units of mmHg·Hz.

Rate Pressure Product Classification

While studies have shown that the myocardial oxygen consumption of the heart estimated by the RPP is an important predictor of congestive heart failure, there are no standards for RPP classifications. It has been found that for an individual, myocardial ischemia and angina are precipitated when the RPP exceeds a threshold that is unique for each individual. It is therefore important that you consult your physician to determine your classification.

Since RPP is dependent on SYS and PRA, factors that affect these values will also affect the RPP. For example, an increase in SYS and PRA due to exercise, mental stress, or drugs will cause an increase in RPP. Similarly, factors like sleep or medications which cause a reduction in SYS and PRA will cause a decrease in RPP.

The following table shows RPP values calculated for varying SYS and PRA. This table shows that having a SYS of 120 mmHg and a PRA of 60 /min, both of which are considered to be normal values, results in an RPP of 120 mmHg·Hz. However, with the same SYS, an increase in PRA has the effect of an increase to the stress on the heart, indicated by the increasing RPP. Similarly, for a constant PRA, an increase in SYS produces the same effect.

chart

Additional Resources

 

Introduction:

Nichols WW, OʼRourke MF. “The Coronary Circulation”, in McDonald’s Blood Flow In Arteries, 5th Edition, London, United Kingdom: Hodder Arnold, 2005, ch16, pp. 301-338, 2005.

Wikipedia. Heart [Online]. Available: http://en.wikipedia.org/wiki/Heart. Accessed: 2011-02-24.

Wikipedia. Coronary disease [Online]. Available: http://en.wikipedia.org/wiki/Coronary_disease. Accessed: 2011-02-24.

F.G. Fletcher et al, “Exercise Standards for Testing and Training: A Statement for Healthcare Professionals from the American Heart Association”. Circulation, vol. 104, pp. 1694-1740, 2001.

P.D. Thompson, “Exercise and Physical Activity in the Prevention and Treatment of Atherosclerotic Cardiovascular Disease: A Statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical”. Arteriosclerosis, Thrombosis, and Vascular Biology, vol. 23, pp. 42-49, 2003.

M. Williams et al, “Resistance exercise in individuals with and without cardiovascular disease: 2007 update: a scientific statement from the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity, and Metabolism”. Circulation, vol. 116, pp. 572-584, 2007.

Rate Pressure Product Classification:

F.G. Fletcher et al, “Exercise Standards for Testing and Training: A Statement for Healthcare Professionals from the American Heart Association”. Circulation, vol. 104, pp. 1694-1740, 2001.

P.D. Thompson, “Exercise and Physical Activity in the Prevention and Treatment of Atherosclerotic Cardiovascular Disease: A Statement from the Council on Clinical Cardiology (Subcommittee on Exercise, Rehabilitation, and Prevention) and the Council on Nutrition, Physical”. Arteriosclerosis, Thrombosis, and Vascular Biology, vol. 23, pp. 42-49, 2003.

M. Williams et al, “Resistance exercise in individuals with and without cardiovascular disease: 2007 update: a scientific statement from the American Heart Association Council on Clinical Cardiology and Council on Nutrition, Physical Activity, and Metabolism”. Circulation, vol. 116, pp. 572-584, 2007.

U.S. Department of Health and Human Service, Agency for Healthcare Research and Quality, National Guideline Clearinghouse. Coronary heart disease (CHD): symptoms, diagnosis and treatment [Online]. Available: http://ngc.gov/content.aspx?id=12788. Accessed: 2011-02-24.