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What does it mean when blood pressure is different between left and right arm?

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Dr. Sathyadharan Panneer

Orthopaedic Surgeon

Practicing since :2004

Answered : 189 Questions

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Posted on Wed, 9 Jan 2013 in Hypertension and Heart Disease
Question: What does it mean when blood pressure is different between left and right arm also in using a wrist monitor which is giving me different reading anyway but it's a major different between arms
doctor
Answered by Dr. Sathyadharan Panneer 3 hours later
Hi,

Thanks for writing in.

A difference in a blood pressure reading between the two arms by a few points is insignificant. But if the difference in systolic reading is > 20 units or diastolic reading is > 10 units, then it signals some block in the peripheral blood vessels (atherosclerosis), diabetes mellitus, Takayasu's arteritis (inflammation in arch of aorta), etc. In acute scenario it can be due to dissection in arch of aorta.

A few points to be remembered before measuring your blood pressure:
1. Avoid caffeine, alcohol, nicotine (smoking), brisk walking/stairs/exercises 30 minutes before you take your reading,
2. While taking measurement, your arm/elbow should be resting at the level of the heart.
3. There should be a minimum of 2-3 minute gap between two readings with cuff fully deflated. This avoids the compensatory rise in blood pressure.

Take average of three such readings. If still you find a significant difference in readings, it's better to consult your doctor and get examined thoroughly to rule-out such possibilities.

Hope I have answered your query. Feel free to ask any doubts.

Get well soon.

Above answer was peer-reviewed by : Dr. Shanthi.E
doctor
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Follow up: Dr. Sathyadharan Panneer 2 hours later
Wow doc are those life threaten because I don't have a primary doc right now... And also it's kinda of confusing me because the reading ate jumping all over the place like its not accurate but when I went to the argent care today they check my bp using the right arm and it was borderline like 138 but when I did the right arm with my wrist monitor at home on the right arm it's been a lot higher at average but the left has been pretty normal
doctor
Answered by Dr. Sathyadharan Panneer 46 minutes later
Hi and thanks again,

Though those are not life threatening, it can be debilitating because if there is a block in peripheral vessels due to atherosclerosis, there can be block in vessels supplying vital organs too which might lead to stroke or heart attack sometime later.

Dissection of aorta is life threatening. Since you don't have symptoms of chest pain, palpitations, cold limb, it cannot be the cause in your case.

That being said, the readings vary between BP apparatus and observer. And any automated blood pressure machine reading need to be verified at your doctor's office to confirm the readings. So I feel the next step is get your blood pressure recorded in all the 4 limbs at a free walk in clinic. And if you find discrepancies, you can act upon it accordingly.

As you have already visited the emergency care and everything seems to be normal, I do not feel you have something severe to worry about.

Hope this helps. Let me know if you need further assistance.

Regards

Above answer was peer-reviewed by : Dr. Prasad
doctor
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Follow up: Dr. Sathyadharan Panneer 16 hours later
Aw ok well I don't really have those problems I went in because if feeling lightheaded and he checked my blood sugar and said that it was find so do you think I'm find on that end because that was a concern too
doctor
Answered by Dr. Sathyadharan Panneer 7 hours later
Since you are asymptomatic even after 24 hrs, i don't think there is any life threatening problem.

I would suggest you to consult your doctor and repeat the BP reading after a week.

Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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