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    B/P varies between arms
    An_247549 posted:
    I have HTN which has been controlled for 20 years on Lisinopril 20mg daily. Recently I lost 50lb with diet an exercise. My B/P had dropped from 140-150's over 70's to 120-124 over 60's and my physician even discussed the possibility of decreasing to 10mg daily. Two months ago I started having right sided headaches, lightheadedness, at times even word search problems where I knew what I wanted to say but couldn't think of the words (new for me). My B/P ranges really changed and that's when I noticed the difference between arms. B/P in the left arm are 170-185/78-85 and right arm 140-155/60's when sitting. Standing the left arm is 189/98 and the right 146/86. My doctor started Lopressor 25mg but after 1 couple of weeks no changes at all and she stopped it. I have left bundle branch block also. Yesterday my B/P left was 210/112 and right 167/89 and I was having chest tightness, vertigo and tremors. Went to ER where they said cardiac labs, CXR, and CT scan of the brain were normal. Gave me Ativan 0.5mg which helped with the tremors slightly. They only took my B/P laying down and it was 155/90's on the left and 130's/80 on the right. Told me my symptoms don't go together and sent me home. I have been a RN for 34 years and I have to say I'm scared. My doctor will be back in town next week and will follow up with her. Have you any ideas? What would make the B/P just rise so high in 2 months? I have not started any new medications, don't take any supplements or herbs, haven't changed my diet... I just don't get it. Would appreciate any help you can offer. Thanks
    cardiostarusa1 responded:

    "What would make the B/P just rise so high in 2 months?"

    The complex human body is usually able to keep blood pressure (BP) within safe/acceptable limits, but sometimes changes in lifestyle, health, side effects from prescription drugs, or changes in metabolism, make this difficult. This can cause the BP to become consistently higher or lower than normal, or spike up and then drop down.

    Compensatory mechanisms that control BP involves changing the diameter of veins and small arteries (arterioles), the amount of blood pumped out from the heart per minute (cardiac output), and the volume of blood in the vessels.

    High BP, temporary or chronic, may/can be related to various heart disorders, kidney problems, and sometimes liver, or adrenal gland problems. One's susceptibility to develop it can even be caused by an imbalance somewhere within the body's precise regulating systems.

    B/P varies between arms

    Usually, but not always, there is only a small difference between blood pressure (systolic and diastolic) readings in both arms.

    It is reported that if the technique for taking the BP readings is good (accurate as possible), it's likely that the respective readings accurately reflect the pressure in each arm, BUT the higher reading reflects the "true" BP.

    If/when there is a clinically significant/substantial difference in BP between one arm and the other (such as hypertension in one arm), this may/can be due to factors and conditions, such as coarctation (narrowing, congenital) of the aorta, aortic dissection (tear in the wall of the aorta), atherosclerosis (plaque buildup), and thrombosis/embolism (blood clot) in an artery in the arm.

    Also, the right and left subclavian artery supplies oxygenated blood to the arms, and in a condition known as subclavian artery stenosis (SAS, most often acquired in life), BP will be lower in the arm with the narrowed subclavian (typically one artery is affected) artery, thus accordingly causing reduced blood flow through it.

    BP begins to rise as one awakens, peaks in the late afternoon or evening, and then drops off gradually, becoming the lowest when sleeping. Normal resting blood BP in adults is under 120/80 with 115/75 or 110/70 considered as being optimal/ideal.

    Taking BP measurements when at rest/relaxed will help yield more consistent readings. If one has had a peaceful night's sleep, then measurements are best taken as soon as one awakes in the morning, as at this time of the day, the body will be at its lowest functioning levels, both physically and mentally, and therefore the factors that affect BP will be minimized. One should try to take the BP at the same time(s) every day.

    PLUS, there was a study, in which University of Virginia researchers tested 100 individuals two times, once while they perched on a doctor's table, feet dangling, and then again as they sat in a chair with both feet resting on the floor and their back and arms supported.

    Systolic BP, the top number, dropped by 13 points on average while sitting in the chair. Why's this? According to study author Melly Turner, RN, if your arm, back, and legs are not supported, then you're exerting energy while being tested.

    The prestigious American Heart Association has been recommending the chair method, but harried medical staff often don't employ it. Sit quietly in a proper chair for 5 minutes before having the BP checked, and be sure the arm being used rests on a flat surface.

    Take care,


    WebMD member (since 8/99)



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