Pulmonary Artery Pressure: Normal Range vs High (Chart)

Normal pulmonary artery pressure at rest is a mean of 8–20 mmHg, with most healthy adults sitting around 14 mmHg. Systolic pressure normally runs 15–30 mmHg and diastolic 4–12 mmHg. A resting mean above 20 mmHg, measured by right heart catheterization, meets the current definition of pulmonary hypertension.

If you have just read “PA pressure” or “PASP” on an echo report, those numbers can be confusing. Pulmonary artery pressure normal values are far lower than the blood pressure taken on your arm, and the cut-off for “high” changed in 2022. Many websites still quote the old 25 mmHg number. This guide gives you the current ranges in one chart, explains how each test measures pressure, and shows you how to read your own result before you talk to your doctor.

What Is Pulmonary Artery Pressure?

Pulmonary artery pressure is the blood pressure inside the vessel that carries oxygen-poor blood from your heart to your lungs. The right ventricle pumps blood into the pulmonary trunk, which splits into the left and right pulmonary arteries. From there, blood moves through thin capillaries around the air sacs, picks up oxygen, and returns to the left side of the heart through the pulmonary veins.

This circuit is built for low pressure. The lungs sit right next to the heart, and their vessels are wide and stretchy, so the right ventricle does not need to push hard. Your arm blood pressure might be 120/80 mmHg. The matching number in the lungs is closer to 25/10 mmHg. If you want the bigger picture, our guide to pulmonary vs systemic circulation walks through both loops side by side.

Because the right ventricle is a thin-walled pump, it handles volume well but copes poorly with pressure. That is why even a modest, lasting rise in lung pressure matters: over months to years it makes the right heart thicken, stretch and eventually tire.

Pulmonary Artery Pressure Normal Range (Chart)

The table below lists resting values measured directly with a catheter. These are the reference ranges published in the 2022 ESC/ERS pulmonary hypertension guidelines, the standard used by specialists in the US and Europe.

Measurement	What it means	Normal at rest	Considered high
Mean pulmonary artery pressure (mPAP)	Average pressure over one heartbeat; the number used to diagnose PH	8–20 mmHg (average about 14)	>20 mmHg
Systolic pulmonary artery pressure (sPAP or PASP)	Peak pressure while the right ventricle squeezes	15–30 mmHg	Above about 35–40 mmHg on echo suggests PH
Diastolic pulmonary artery pressure (dPAP)	Lowest pressure, between beats	4–12 mmHg	Rises with left heart disease or PH
Pulmonary arterial wedge pressure (PAWP)	Back-pressure from the left side of the heart	Up to 12 mmHg (guideline cut-off 15)	>15 mmHg points to a left heart cause
Pulmonary vascular resistance (PVR)	How stiff or narrowed the lung vessels are	0.3–2.0 Wood units	>2 Wood units
Tricuspid regurgitation velocity (TRV, echo)	Speed of a small backward jet across the tricuspid valve	2.8 m/s or less	>2.8 m/s raises suspicion; >3.4 m/s high probability

A quick rule of thumb: the mean pressure is the diagnostic number. Systolic pressure is what you usually see on an echo report, and it is only an estimate.

Normal vs High: Where Is the Line Now?

Pulmonary hypertension (PH) is now defined as a resting mPAP above 20 mmHg on right heart catheterization. That definition comes from the 2022 ESC/ERS guidelines and was confirmed by the 7th World Symposium on Pulmonary Hypertension in 2024. It applies to adults and children.

Pressure alone does not tell the whole story. Doctors add two more measurements to work out why the pressure is high:

• Pre-capillary PH (mPAP >20, PAWP ≤15, PVR >2 Wood units): the problem is in the lung arteries themselves. This includes pulmonary arterial hypertension (Group 1), PH from lung disease and PH from old clots.
• Post-capillary PH (mPAP >20, PAWP >15): pressure is backing up from the left side of the heart, as in heart failure or mitral valve disease. This is Group 2 PH, the most common type in the US.
• Exercise PH: resting numbers are normal, but pressure climbs too steeply during exercise (an mPAP/cardiac output slope above 3 mmHg/L/min).

The wedge pressure piece is explained in more detail in our article on pulmonary capillary wedge pressure.

Why You Still See “25 mmHg” Online

For about 50 years, PH meant a resting mPAP of 25 mmHg or higher. That figure was chosen by an expert meeting in 1973, not from careful study of healthy people. Later research measured thousands of healthy adults and found the average was about 14 mmHg, with an upper limit near 20. Studies also showed that people with an mPAP of 21–24 mmHg had a higher risk of death and of developing full PH than people below 20.

So the line moved to “above 20.” Plenty of older pages, including some government patient pages and the earlier version of this article, still list 25. If your report says 22 or 23 mmHg, older sources may call that normal or “borderline,” while current guidelines count it as PH. Your specialist will interpret it alongside wedge pressure, resistance and your symptoms. Effective drug treatment has mainly been tested in people with higher pressures, so a reading of 21–24 often means closer follow-up rather than immediate medication.

How Pulmonary Artery Pressure Is Measured

There are two main tests, and they answer different questions. Our full guide on how pulmonary hypertension is measured covers less common options such as cardiac MRI and implanted sensors.

Echocardiogram: the screening test

An echo is an ultrasound of the heart. It cannot see pressure directly. Instead, it measures how fast a small jet of blood leaks backward through the tricuspid valve (the TRV). The faster the jet, the higher the pressure the right ventricle is pushing against. The machine converts this to an estimated systolic pressure using the formula 4 × TRV² plus an estimate of right atrial pressure.

Echo estimates can be off by 10 mmHg or more in either direction. Poor image windows, severe valve leaks, lung disease and obesity all reduce accuracy. That is why current guidelines ask echo readers to report a probability of PH (low, intermediate or high) based on TRV plus signs of right heart strain, rather than relying on a single pressure figure.

Right heart catheterization: the confirming test

A thin catheter is passed through a vein in the neck, arm or groin into the right side of the heart and the pulmonary artery. It measures mean pressure, wedge pressure and cardiac output directly, so the doctor can calculate resistance. This is the only test that can confirm PH and classify its type. In experienced PH centers, serious complications occur in about 1 in 100 procedures. The full diagnostic workup for pulmonary hypertension usually includes blood tests, breathing tests and imaging as well.

How to Read Your Echo or Cath Report

This is the part most articles skip. If you have a report in hand, work through it in this order:

1. Check which test it was. Echo reports usually give “RVSP,” “PASP” or “estimated PA systolic pressure.” Cath reports give “PA mean” or “mPAP.” Do not compare an echo systolic number with the 20 mmHg mean cut-off; they measure different things.
2. Find the TRV on an echo. A TRV of 2.8 m/s or less with no other right heart signs means a low probability of PH. Between 2.9 and 3.4 m/s is intermediate. Above 3.4 m/s is high probability.
3. Look for right heart signs. Phrases like “dilated right ventricle,” “flattened septum,” “enlarged right atrium” or “dilated IVC” add weight to a borderline pressure.
4. On a cath report, read three numbers together. mPAP tells you if PH is present. PAWP (wedge) tells you if the left heart is involved. PVR tells you if the lung vessels themselves are diseased.
5. Consider your context. Age, weight, altitude, anemia, pregnancy and liver disease can all nudge pressures up. An echo systolic estimate of up to 35–40 mmHg can be normal in older or heavier adults.
6. Write down your questions. Ask what group of PH, if any, your doctor suspects, and whether a cath or referral to a PH center is the next step.

Things That Change Pulmonary Pressure in Healthy People

• Age: Mean pressure creeps up slowly with age. In large studies, healthy adults over 50 averaged about 15 mmHg versus about 13 in people under 30, still well under 20.
• Exercise: Pressure rises during exercise because more blood flows through the lungs. In healthy people the lung vessels widen and recruit unused capillaries, so the rise is modest. An exaggerated rise can be an early warning sign.
• Altitude: Low oxygen makes lung arteries tighten, a reflex called hypoxic pulmonary vasoconstriction. People who live above about 8,000 feet often have slightly higher pressures.
• Body position and breathing: Readings are taken lying flat at the end of a normal breath out, so pressure swings with breathing do not distort the result.
• High blood flow: Anemia, pregnancy, an overactive thyroid and liver cirrhosis increase how much blood the heart pumps, which can raise mPAP without true vessel disease.

What Causes High Pulmonary Artery Pressure?

Doctors sort the causes into five groups of pulmonary hypertension:

• Group 1, pulmonary arterial hypertension: idiopathic or inherited disease, connective tissue disease such as scleroderma, certain drugs including methamphetamine, HIV and liver disease.
• Group 2, left heart disease: heart failure (especially with preserved ejection fraction) and mitral or aortic valve disease. This is the most common cause in the US.
• Group 3, lung disease or low oxygen: COPD, interstitial lung disease and hypoventilation syndromes.
• Group 4, blocked pulmonary arteries: mainly chronic clots left after a pulmonary embolism (CTEPH).
• Group 5, unclear or mixed causes: sickle cell disease, sarcoidosis, chronic kidney failure and others.

For a deeper look at each, see our full guide to the causes of pulmonary hypertension. If you are wondering how this condition differs from ordinary high blood pressure, read hypertension vs pulmonary hypertension.

Symptoms of High Pulmonary Pressure

Early PH often causes no symptoms at rest. The first sign is usually breathlessness with activity that feels out of proportion, such as needing to stop halfway up a flight of stairs you used to climb easily. Other symptoms include:

• Tiredness and reduced exercise tolerance
• Chest pressure or pain with exertion
• Lightheadedness or fainting during or right after activity
• Swelling of the ankles, legs or belly
• A racing or pounding heartbeat
• Bluish lips or fingertips in advanced cases

Because these overlap with asthma, deconditioning and heart disease, it takes more than two years on average to diagnose pulmonary arterial hypertension. If you have a risk factor such as scleroderma, a past pulmonary embolism or a family history of PAH, mention it early.

Can High Pulmonary Pressure Come Back Down?

Often, yes, at least partly. The answer depends on the cause:

• Treating heart failure or repairing a leaky valve can lower Group 2 pressures.
• Oxygen therapy for people with low oxygen levels and treatment of the underlying lung disease can help Group 3.
• Surgery or balloon angioplasty can remove or open old clots in CTEPH and sometimes bring pressures back to normal.
• Group 1 PAH has a range of targeted medicines that relax and remodel the lung arteries; your specialist chooses these based on a risk assessment.

See how pulmonary hypertension is treated for details on each approach. For outlook and survival, our articles on how serious pulmonary hypertension is and life expectancy with pulmonary hypertension explain what affects prognosis.

When to See a Doctor

Book an appointment if you have breathlessness, tiredness or ankle swelling that is new or getting worse, or if an echo has flagged a raised PA pressure or a TRV above 2.8 m/s. Ask whether you need a referral to a pulmonologist or cardiologist with PH experience. You can find a pulmonologist near you in our directory.

Call 911 right away if you faint, have sudden severe shortness of breath, chest pain, cough up blood, or notice sudden one-sided leg swelling with breathlessness. These can be signs of a pulmonary embolism or right heart failure. Here is how to spot a pulmonary embolism.

Key Takeaways

• Normal mean pulmonary artery pressure at rest is 8–20 mmHg, averaging about 14 mmHg.
• Normal systolic is 15–30 mmHg and diastolic 4–12 mmHg.
• Pulmonary hypertension is now defined as a resting mean above 20 mmHg on right heart catheterization, down from 25 mmHg before 2022.
• An echo gives an estimate; a TRV above 2.8 m/s or an estimated systolic above about 35–40 mmHg calls for a closer look.
• Wedge pressure and vascular resistance tell doctors why pressure is high, which decides treatment.
• Many causes are treatable, so an abnormal reading is a reason for follow-up, not panic.

Frequently Asked Questions

What is a normal pulmonary artery pressure on an echocardiogram?

Most labs consider an estimated systolic pressure (PASP or RVSP) of up to about 30–35 mmHg normal, with a TRV of 2.8 m/s or less. In older or overweight adults, up to about 40 mmHg can still be normal. Echo numbers are estimates, so a borderline result is usually judged together with signs of right heart strain.

Is a pulmonary artery pressure of 35 mmHg high?

It depends on which number it is. An echo systolic estimate of 35 mmHg is borderline and often normal, especially if you are over 60. A cath-measured mean pressure of 35 mmHg is clearly high and meets the definition of pulmonary hypertension.

Is pulmonary artery pressure normal range different with age?

Slightly. Mean pressure rises by a mmHg or two between young adulthood and later life, but healthy people of any age rarely exceed 20 mmHg at rest. Echo systolic estimates vary more with age, which is why older adults may have readings up to about 40 mmHg without disease.

What is the difference between PASP and mPAP?

PASP is the peak (systolic) pressure, usually estimated by echo. mPAP is the average pressure across the whole heartbeat, measured by catheter. Pulmonary hypertension is diagnosed using mPAP, with a cut-off of more than 20 mmHg.

Is 22 mmHg pulmonary pressure considered pulmonary hypertension?

Under current guidelines, a resting mean of 22 mmHg on catheterization meets the definition of PH, though older sources called it borderline. Whether it needs treatment depends on wedge pressure, vascular resistance, the cause and your symptoms.

Can anxiety or exercise raise pulmonary artery pressure?

Exercise raises it temporarily in everyone, and a fast heart rate from anxiety can nudge an echo estimate upward. These short-lived changes are not pulmonary hypertension, which is defined by resting pressure measured under controlled conditions.

Can high pulmonary artery pressure go back to normal?

Sometimes. When the cause is fixable, such as a valve problem, untreated sleep-related low oxygen or chronic clots that can be removed, pressure can fall substantially or normalize. Long-standing pulmonary arterial hypertension is usually managed rather than cured.

References

1. Humbert M, Kovacs G, Hoeper MM, et al. 2022 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension. European Heart Journal. 2022;43(38):3618–3731.
2. Kovacs G, Bartolome S, Denton CP, et al. Definition, classification and diagnosis of pulmonary hypertension (7th World Symposium on Pulmonary Hypertension). European Respiratory Journal. 2024;64(4):2401324.
3. Updated clinical classification and hemodynamic definitions of pulmonary hypertension and its clinical implications. Review, PubMed Central (NCBI).
4. National Heart, Lung, and Blood Institute. What is pulmonary hypertension? NIH.
5. Kovacs G, Berghold A, Scheidl S, Olschewski H. Pulmonary arterial pressure during rest and exercise in healthy subjects: a systematic review. European Respiratory Journal. 2009;34(4):888–894.

This article is for general education and is not a substitute for advice from your doctor.