Factors That Can Exaggerate Blood Pressure Readings
When you go to the doctors office, blood pressure measurement is one of the ways doctors can check up on your heart health. The only way to diagnose high blood pressure, known as hypertension, is by a blood pressure test. Blood pressure readings are typically taken at the start of your doctors appointment.
A healthy blood pressure reading is anywhere between 90/60 and 120/80. To understand your blood pressure reading, you need to know the difference between diastolic and systolic blood pressure. The first number is the systolic blood pressure which measures how much pressure your blood is exerting against the artery walls when your heart is beating. The second number is the diastolic blood pressure which indicates how much pressure your blood is exerting against your artery walls while the heart is resting between beats.
Anything 140/90 or above is considered a high blood pressure reading, which could be a diagnosis of hypertension. Hypertension is one of the leading causes of heart disease that can lead to heart attacks, kidney failure, stroke, and even dementia. If your blood pressure measures below 90/60, that could be an indicator of hypotension, or low blood pressure, which can result in dizziness, fainting, and long-term damage to the heart and brain.
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A Wrong Diagnosis Can Lead To Serious Medical Problems That Can Be Fatal
The following are medical conditions that can result from having different BP in each arm. If BP is never taken in both arms, the opportunity to correct or prevent these conditions is reduced.
Peripheral Artery Disease : PAD is a narrowing of your arteries that serve your stomach, legs, arms and head. People with PAD are at a higher risk of stroke, heart attack and coronary artery disease. PAD can also lead to an amputation and gangrene. If PAD is diagnosed early, it may be treated with lifestyle changes and medication .
Aortic Dissection: Its uncommon and is a less common cause of blood pressure different in each arm. Aortic dissection happens when the inner layer of the aorta tears. Blood flows through the tear which causes the inner and middle layers of the aorta to separate. If this blood filled area breaks through the outer wall of the aorta, the result is often fatal.
Problems In Young People: A younger person can have BP different in each arm but usually for different reasons. Blood flow through an artery may be disrupted because of a structural issue. Another reason may be when something inside the body, like a muscle, can press down on an artery and restrict the blood flow.
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Ambulatory Blood Pressure Monitoring
Having a raised blood pressure reading in 1 test does not necessarily mean you have high blood pressure.
Blood pressure can fluctuate throughout the day. Feeling anxious or stressed when you visit your GP can also raise your blood pressure.
If you have a high reading, you may be asked to take some readings with a 24-hour monitor that checks your blood pressure throughout the day.
This will confirm whether you have consistently high blood pressure.
It’s known as 24-hour or ambulatory blood pressure monitoring.
Blood Pressure Higher In The Left Arm
Higher blood pressure is more often found in the right arm. Having varying blood pressure in different arms is statistically normal and may not necessarily be a cause for concern. However, if the difference is persistent, your health care provider will use the arm with the higher blood pressure for all further blood pressure measurements.
Your health care provider might want to check for certain medical conditions if you have a blood pressure difference between your arms, particularly if its persistent and large. They might check for:
- Coarctation of the thoracic aorta
- Dissection of the thoracic aorta
- Aneurysm of the aorta
- Various kinds of extra- and intra-arterial obstruction in the upper extremities
- Takayasu disease
These causes for a blood pressure difference between arms become more likely when the arm with the lower blood pressure also has a diminished pulse.
According to studies, people with a blood pressure difference of 15 points or more between arms are twice as likely to develop peripheral artery disease. Peripheral artery disease is when your arteries become clogged or blocked by cholesterol. It affects about 12 million people in the United States. A blood pressure difference of 10 to 15 points between arms may also raise your likelihood of dying from heart disease or getting a stroke.
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Why Might Your Blood Pressure Be Different Between Your Two Arms
Your heart sits just to the left of the midline in your chest cavity. The largest blood vessel in the body, the aorta, leaves through the left side of the heart and transports blood to a network of branching blood vessels that supply the body with oxygen and nutrients.
The arteries that branch off the aorta and go towards the left and right sides of the body are different. On the right side, the brachiocephalic trunk comes off the aorta and splits into the right common carotid artery and right subclavian artery. The left common carotid and left subclavian arteries to come directly off the aorta. These differences mean that the risk for increased turbulence leading to arterial thrombosis is not the same for the right and left subclavian arteries. Arterial thrombosis causes blood vessel stiffening and obstruction over time and is four times more likely in the left subclavian than in the right. The difference in arterial branching affects the blood pressure measured on the left and right arms.
Blood vessels are surrounded by muscle, fat, and connective tissue. When muscles put pressure on the blood vessels around the heart, it can cause transient turbulence, which may affect blood pressure. However, this effect on blood pressure should be temporary and minor, which is why its important to understand your blood pressure on both sides of the body.
New Study Shows Decline In Control Of High Blood Pressure
Based on the new findings, Clark and his colleagues say that a difference of more than 10 mmHg between the two arms should be a cause for concern.
We think the difference we are measuring is caused by changes leading to stiffening of the arteries, Clark said in an email. Stiff arteries are associated with cardiovascular events and death.
While it might seem that a lower blood pressure in one arm might be good news, the opposite is true.
It is likely that meaningful differences in blood pressure between the left and right arms indicates a narrowing of major arteries due to atherosclerosis , said study co-author Dr. Mary McDermott, a professor at the Northwestern University Feinberg School of Medicine in Chicago.
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Which Arm To Choose For Blood Pressure Measurement
According to the recommendations by the American Heart Association, the health care provider should measure your blood pressure in both your arms in case theres a difference. Your health care provider will use the higher blood pressure number to make decisions about treatment. You should also follow the below-mentioned guidelines during blood pressure measurement:
- Avoid drinking caffeinated beverages or smoking about half an hour before BP measurement.
- Sit quietly for at least five minutes before being measured.
- During BP measurement, sit comfortably in a chair. Keep your feet on the ground and support your arm so that your elbow is at the level of your heart.
- The inflatable portion of the cuff should cover about 80 percent of your upper arm. The health care provider will place it on your skin and not over a shirt.
- Avoid talking during the measurement.
Does Measuring Your Blood Pressure On The Left Or Right Arm Matter
Your body may look symmetric, but if you look a little closer, you may notice that one eye may be a bit lower than the other, or maybe one hand or foot is a little larger. Inside your body, most of your organs, including blood vessels, are arranged asymmetrically, so what does this mean for your blood pressure?
Blood pressure can vary between your right and left arms and the reason for this could simply be caused by a muscle pressing on a blood vessel, causing turbulence in the body. However, it could be much more serious and a sign of cardiovascular disease, which can lead to strokes, heart attacks, or blood vessel damage. Continue reading to find out why its important to check your blood pressure in both arms and what to do if theyre not the same.
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Understanding Your Blood Pressure Reading
Blood pressure is measured in millimetres of mercury and is given as 2 figures:
- systolic pressure the pressure when your heart pushes blood out
- diastolic pressure the pressure when your heart rests between beats
For example, if your blood pressure is “140 over 90”, or 140/90mmHg, it means you have a systolic pressure of 140mmHg and a diastolic pressure of 90mmHg.
As a general guide:
- high blood pressure is considered to be 140/90mmHg or higher or 150/90mmHg or higher if you’re over the age of 80
- ideal blood pressure is usually considered to be between 90/60mmHg and 120/80mmHg, while the target for over-80s is below 150/90mmHg
Blood pressure readings between 120/80mmHg and 140/90mmHg could mean you’re at risk of developing high blood pressure if you do not take steps to keep your blood pressure under control.
Page last reviewed: 23 October 2019 Next review due: 23 October 2022
Systemic Arterial Pressure And Age
Fetal blood pressure
In pregnancy, it is the fetal heart and not the mother’s heart that builds up the fetal blood pressure to drive blood through the fetal circulation. The blood pressure in the fetal aorta is approximately 30 mmHg at 20 weeks of gestation, and increases to approximately 45 mmHg at 40 weeks of gestation.
The average blood pressure for full-term infants:
- Systolic 6595 mmHg
In children, the normal ranges for blood pressure are lower than for adults and depend on height. Reference blood pressure values have been developed for children in different countries, based on the distribution of blood pressure in children of these countries.
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Why You Should Take Your Own Blood Pressure At Home Or On The Go
Because of regular fluctuations in blood pressure, white-coat syndrome, and masked hypertension, doctors may recommend self-monitoring for people with HBP. There are many benefits to taking your own BP:
- Knowing your actual, average blood pressure outside of regular fluctuations
- Gaining more control over your blood pressure
- Tracking your progress
- Saving time and possibly money from frequent doctor visits and complications
What Should I Do If My Blood Pressure Is 160 Over 100
Your doctor If your blood pressure is higher than 160 / 100 mmHg, then three visits are enough. If your blood pressure is higher than 140/90 mmHg, then five visits are needed before a diagnosis can be made. If either your systolic or diastolic blood pressure stays high, then the diagnosis of hypertension can be made.
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Latest High Blood Pressure News
Thatâs the finding of an analysis of 24 past studies: When people have at least a 5-point difference in blood pressure between the two arms, their risk of heart attack, stroke or premature death inches up. And the greater the difference, the more those risks climb.
Experts said the findings give more support to something thatâs been advocated, but not commonly done by doctors and nurses: Checking patientsâ blood pressure in both arms.
âUnfortunately, blood pressure is not routinely measured in both arms,â said Dr. Jeffrey Berger, a cardiologist who was not involved in the study. âBut I think it should be.â
Berger directs the Center for the Prevention of Cardiovascular Disease at NYU Langone Health in New York City. He said he always checks blood pressure in both arms, and thinks it should be a matter of routine in all patients.
âItâs such a simple thing to do,â Berger said.
Itâs not that the blood pressure difference, itself, is the problem. But a discrepancy between arms might be a sign of early atherosclerosis that is developing asymmetrically, Berger explained.
Instead, he explained, doctors can consider between-arm differences one âmarkerâ of a patientâs heart disease risk.
Pointers For Measuring Your Blood Pressure At Home
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Just as American Heart Month begins, a reader sent in a question on checking blood pressure at home — which, as it turns out, is more nuanced than it looks. So whats the proper way to go about it?
There are a couple of concerns when using a home monitoring device to measure blood pressure: which arm to use, and how long to wait before testing. Luckily, the Mayo Clinic and the American Heart Assn. have some guidance on the subject.
Theres usually a slightly measurable difference in blood pressure between your arms, according to the heart association. Your dominant arm will probably be higher. If youre left-handed, pressure may be higher in the left arm, and vice versa.
It shouldnt make a huge difference, but, the association adds: If one arm has higher blood pressure than the other, that arm should be used to determine if you have hypertension.
Note: If the difference in readings between your left and right arms tops more than 10 mm Hg , there could be other underlying problems that should be checked out with your doctor.
As for how long to rest before taking your blood pressure, the Mayo Clinic suggests three to five minutes the Cleveland Clinic suggests five to 10. Essentially, all you need is enough time to sit quietly and relax.
Finally, heres a handy video from the Mayo Clinic on how to measure your blood pressure using an automatic monitor.
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Which Arm To Take Blood Pressure
Left or right? Its a question I hear from many people when discussing which arm to take blood pressure from. The biggest surprise about this question is when I hear it from a nurse or medical assistant at the doctors office. Thats the last question they should be asking me. If youre a return patient, they will know already the answer to that question. If its the first time at a new doctor, the answer is not right or left.
Which arm to take blood pressure? Which arm to take blood pressure at an initial doctor visit should be both arms. For each subsequent measurement, the arm that recorded the higher blood pressure should be used. Both arms should be measured because a significant difference in BP readings between the right and left arm could signal vascular disease and a greater risk of dying from heart disease.
So when was the last time your blood pressure was checked in both arms? If your blood pressure is taken in one arm that is lower than the other arm, it can give a false indication that your blood pressure is not high. In addition, you can be misdiagnosed with high or low blood pressure. A 69 year old woman was admitted to the hospital for this reason. Ill tell you her story later. Now you know why Im shocked when a nurse asks me what arm.
Effect Of Raising Arms On Blood Pressure
Having your arm raised to any level above the heart will lower your blood pressure . The higher your arm cuff is raised the lower the pressure will be. For every inch your arm is raised above heart level, your readings may lower by 2 mmHg .
A study was conducted of 128 people who held their arms in different positions while their pressure was measured. When their arms were held slightly lower than heart level, both systolic and diastolic blood pressure were higher . When their arms were positioned higher, their BP measurements were lower.
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