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Blood pressure: Can it be higher in one arm?
By Mayo Clinic staffOriginal Article: http://www.mayoclinic.com/health/blood-pressure/AN00357
- With Mayo Clinic emeritus hypertension specialist
Sheldon G. Sheps, M.D.
read biographyclose windowBiography of
Sheldon G. Sheps, M.D.
Sheldon Sheps, M.D.
Dr. Sheldon Sheps, emeritus professor of medicine and former chair of the Division of Nephrology and Hypertension in the Department of Medicine at Mayo Clinic, has been with Mayo Clinic since 1960.
Dr. Sheps, a Winnipeg, Manitoba, native, is board certified in internal medicine and specializes in hypertension and peripheral vascular diseases. He developed a multidisciplinary approach with specially trained nurses, dietitians, technicians and educators to help form a team approach to the treatment of patients with abnormal blood pressure.
"I have always believed in involving the patient and family in their health care," Dr. Sheps says. "I have asked for their understanding of the illness and issues and for participation in decisions. The Web is a natural extension of that, and now many more people can be informed."
Dr. Sheps chaired the sixth working group, and he participated in the fourth, fifth and seventh groups that developed the then-latest guidelines for hypertension under the auspices of the National Heart, Lung, and Blood Institute (NHLBI). He helped write the latest American Heart Association (AHA) report on blood pressure measurement. He chaired an AHA group that produced an online accreditation for blood pressure measurement for health professionals.
Dr. Sheps has co-authored books, newsletters, CD-ROMs and other Mayo Clinic health information material. He joined Mayo Clinic's Web team in 1998. He was medical editor-in-chief of both editions of the "Mayo Clinic on High Blood Pressure" book; the last edition was published in 2003. He was also medical editor-in-chief of "Mayo Clinic 5 Steps to Controlling High Blood Pressure," published in 2008.
In addition, Dr. Sheps was section editor for each of the first three editions of "Hypertension Primer" for the American Heart Association.
Dr. Sheps was also chairman of the Science Base Subcommittee and the National High Blood Pressure Education Program, and he was a consultant to the Hypertension Initiative of the World Health Organization. In 1997, he was honored with the Individual Achievement Award on the 25th anniversary of the National High Blood Pressure Education Program of NHLBI. In 2009, he was honored as a Distinguished Mayo Alumnus.
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Question
Blood pressure: Can it be higher in one arm?
When I measure my blood pressure at home, I've noticed that the reading is always higher in one arm. Should I be concerned?
Answer
from Sheldon G. Sheps, M.D.
Generally, a small difference in blood pressure readings between arms isn't a health concern. However, a difference of more than 20 millimeters of mercury (mm Hg) for systolic pressure (top number) or more than 10 mm Hg for diastolic pressure (bottom number) may be a sign of an underlying problem — such as narrowing of the main arteries to that arm. If you have a significant difference in blood pressure readings between arms, talk to your doctor.
A difference of 10 to 15 mm Hg for systolic pressure that shows up repeatedly is a risk marker for vascular disease and for a greater risk of developing cardiovascular disease and related complications during the next 10 years.
Your doctor may measure your blood pressure in both arms to see if you have high blood pressure (hypertension). If your blood pressure is higher in one arm, your doctor will probably use the blood pressure reading from that arm to monitor your blood pressure.
A large difference in blood pressure measurement between your arms could signal a health problem, such as:
- Blocked arteries in your arms (peripheral artery disease)
- Kidney disease
- Diabetes
- Heart defects
Free blood pressure machines: Are they accurate?
- Bonow RO, et al. Braunwald's Heart Disease: A Textbook of Cardiovascular Medicine. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4377-0398-6..C2009-0-59734-6--TOP&isbn=978-1-4377-0398-6&about=true&uniqId=236798031-10. Accessed Sept. 26, 2012.
- Clark CE, et al. The difference in blood pressure readings between arms and survival: Primary care cohort study. British Medical Journal. 2012;344:e1327.
- Clark CE, et al. Association of a difference in systolic blood pressure between arms with vascular disease and mortality: A systematic review and meta-analysis. The Lancet. 2012;379:905.
- Sheps SG (expert opinion). Mayo Clinic, Rochester, Minn. Sept. 30, 2012.
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