The pulse wave is made up of three components, the anacrotic limb, the catacrotic limb and the dicrotic notch or incisura.
A number of factors influence the pulse wave shape and pulse pressure. Increased stroke volume and decreased heart rate increase the pulse pressure, a fact often observed in endurance athletes. The reason for this can be explained by considering the concept of "run-off". It takes a certain period of time for blood in the aorta to run-off to the peripheral vessels, resulting in a fall in arterial blood pressure toward diastolic.
Decreasing the heart rate increases the time for run-off due to a longer cardiac cycle; whereas, increasing stroke volume increases the volume of blood ejected into the aorta, therefore raising systolic pressure.
Age, hypertension, aortic valve insufficiency, atherosclerosis, and relative position in the arterial tree also increase pulse pressure. Decreased stroke volume and increased heart rate of course decrease pulse pressure.
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