Rate-Pressure Product (RPP)
Estimates myocardial oxygen demand as the product of heart rate and systolic blood pressure. Used to assess cardiovascular workload during exercise testing or perioperative monitoring.
Score interpretation
RPP < 10,000: Low myocardial oxygen demand. Resting or minimal exertion state.
→ Acceptable haemodynamic state. Monitor during exercise testing for ischaemic threshold.
RPP 10,000–20,000: Moderate myocardial oxygen demand. Typical sub-maximal exercise range.
→ In patients with CAD, watch for angina or ECG changes. Angina threshold typically occurs at RPP ~20,000.
RPP > 20,000: High myocardial oxygen demand. Above anginal threshold for most CAD patients.
→ Monitor for angina, ST changes, arrhythmia. Stop exercise testing if symptoms develop. Ceiling for exercise stress test = 85% maximal predicted HR.
Interpretation bands for the Rate-Pressure Product. Apply clinical judgement and local guidance.
References
- Nelson RR, et al. Hemodynamic predictors of myocardial oxygen consumption during static and dynamic exercise. Circulation. 1974;50(6):1179–1189.
Related
Curated clinical cross-links plus same-class fallbacks.
- Isosorbide Mononitrate (Stable Angina) · Nitrate / Stable Angina
- Nicorandil · Stable Angina
- Ranolazine · Refractory Stable Angina
- Colchicine (Pericarditis / Post-MI Inflammation) · Pericarditis / Coronary Inflammation
- Glyceryl Trinitrate (Sublingual / IV) · Nitrate / Acute Angina
- Methotrexate (Dermatology — Psoriasis) · Disease-Modifying Antirheumatic / Immunosuppressant
- Acute Heart Failure · ESC 2021 Heart Failure Guidelines; NICE NG106
- NSTEMI / Unstable Angina · ESC 2020 NSTEMI Guidelines; NICE NG185
- New-Onset Atrial Fibrillation · ESC 2020 AF Guidelines; NICE NG196
- Hypertensive Emergency · ESC/ESH 2018 Hypertension Guidelines; NICE NG136
- Bradycardia Management · Resuscitation Council UK ABCDE; ESC 2021 Pacing Guidelines
- Ventricular Tachycardia / Fibrillation · Resuscitation Council UK ACLS; ESC 2022 Ventricular Arrhythmia Guidelines
Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.