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Forum Name: Hypertension

Question: bp 200/140 one arm only


 dama - Sun Jan 06, 2008 2:05 am

Hi,
I'm a 37 yo healthy white female. History of high bp more than 5 years ago (lasted for 3 years, usually in the 140s over 90s) - went up with weight gain, managed with meds, off meds and fine after weight loss. I have gained 30lbs within recent months. BP has been fine until Nov when I went to dr for URI where it was elevated to 140/104. NP wanted to watch it and it went down (around 135/97). Went again for continued cough in Dec and it was slightly elevated but less than the first time.

This past week I have been monitoring at home. I bought a manual monitor so I could use the stethoscope to watch my son's lungs - he was having strong bronchospasms. I have consistently had high readings with an average of 175/112. Tonight I took it in both arms because it seemed like there was a difference. My right arm (dominant) was 200/140 and left was 175/115. This freaked me out a bit so I waited and retook after 1 1/2 hours and it went down to 175/115 in right and 150/98 in left. Why is there so much difference? I do have some muscle weakness and pain in my right arm that is on and off since summer - NP thinks it may be tendonitis. Could this explain the difference?

Also, tonight I've had some "bruising" from the cuff (dotted lines up and down arm like broken blood vessels). Is it possible I'm doing something wrong? I grew up experimenting with bp monitors because my dad has had high bp for years and his father died from a heart attack in his 40s. So we used to take ours for fun. I think I know how to do it, but I've never had such high readings. And why would it be so high over such a short period of time? Can I wait to lose weight or do I need to do meds? Also, my mother (and 2 sisters) have high bp treated by meds and my mother's father died (in 70's) of heart attack.

Please advise. Many thanks!
 Dr. Chan Lowe - Tue Feb 12, 2008 2:11 am

User avatar Hello Dama,

These blood pressures are quite high. Ordinarily, when one sees an elevated blood pressure in the right arm is significantly higher than the left arm it can indicate that there is a narrowing of the aorta between the take off of the two subclavian arteries, called coarctation of the aorta. It would be very unusual to have this condition and not have it diagnosed until adulthood. It may be that the difference in blood pressure is not actually a significant difference.

I would definitely recommend that you have this reevaluated by your doctor. Loosing weight will likely help your blood pressure, but at these measurements I would not personally be comfortable waiting for weight loss and would start a blood presssure medicine if your pressures are confirmed that high.

I would also recommend you see a cardiologist for an evaluation of your heart to see if the underlying cause can be determined. Tendonitis is very unlikely to be a cause of the elevated blood pressures. The bruising may simply be due to the elevated pressure from the cuff since you are needing to use higher pressures.

Follow up with your doctor is very important.

Best wishes.

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