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Medical Applications

Rate-Pressure Product (RPP)

Definition and Calculation

The Rate-Pressure Product is the product of systolic blood pressure and heart rate:

RPP = Heart Rate (bpm) × Systolic BP (mmHg)

Physiological Significance

RPP is a well-validated, non-invasive index of myocardial oxygen demand. It correlates closely with direct measurements of myocardial oxygen consumption (MVO₂) obtained via coronary sinus catheterisation and is routinely used in clinical exercise physiology and cardiology to estimate cardiac workload. The clinical utility of RPP was established in the context of exercise stress testing, where anginal threshold typically corresponds to a patient-specific RPP value that reproducibly provokes ischaemia.

In patients with significant coronary artery disease, angina pectoris typically occurs when RPP exceeds approximately 20,000 during exertion. At rest, persistently elevated RPP indicates that the myocardium is working under unnecessary demand, which may reflect inadequately controlled hypertension, tachycardia, or both. Monitoring resting RPP in patients on antihypertensive or rate-controlling therapy provides a sensitive integrated measure of therapeutic efficacy.

Reference Ranges