Normal Pulmonary Artery Pressure
Normal mean pulmonary arterial pressure (mPAP) at rest is 14 ± 3 mmHg, with an upper limit of normal of approximately 20 mmHg. 1
Mean Pulmonary Arterial Pressure (mPAP)
- The normal mPAP at rest in healthy individuals is 14 ± 3 mmHg 2, 1
- The upper limit of normal is 20 mmHg 2, 1
- Values between 21-24 mmHg represent a gray zone with uncertain clinical significance, though these mild elevations are associated with increased mortality 2, 3
- Pulmonary hypertension is formally defined as mPAP ≥25 mmHg at rest by the 2009 ESC/ERS guidelines 2, though more recent 2018 consensus has lowered this threshold to >20 mmHg 2, 3
Pulmonary Artery Systolic Pressure (PASP)
- In healthy individuals, the average PASP measured by right heart catheterization is approximately 21 ± 4 mmHg 1
- The upper limit of normal PASP is around 30 mmHg 1
- On echocardiography, estimated PASP (ePASP) >30 mmHg is generally outside the normal range in most healthy individuals 1
Important Clinical Considerations
Age and body habitus affect normal values. Among echocardiographically normal subjects, PASP increases with age and body mass index (BMI), with 6% of those >50 years old and 5% of those with BMI >30 kg/m² having PASP >40 mmHg 4. This supports using age- and BMI-corrected values when interpreting pulmonary pressures 4.
Right heart catheterization remains the gold standard for measuring pulmonary artery pressure and is required to confirm a diagnosis of pulmonary hypertension 3, 1. Echocardiography can estimate PASP using the tricuspid regurgitant jet velocity with the modified Bernoulli equation, but is insufficient alone to support treatment decisions for specific pulmonary hypertension therapy 3.
Exercise values cannot be definitively defined. The 2009 ESC/ERS guidelines explicitly state that no definition for pulmonary hypertension on exercise can be provided, as healthy individuals can reach much higher values during exertion 2.