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Forum Name: Hypertension

Question: Difference in blood pressure in each arm?


 OUBETA - Mon Jul 14, 2003 4:38 pm

I'm 23 years old and an avid weight lifter. I'm getting ready to start taking a few supplements so I decided to get my Bp checked before I start. I know I will retain a little water, which inturs raises my Bp while on my supplements.

I check it 7 times a day in each arm and average the totals.

Left arm is 145/80. Which is wayyy high considering my diet and cardio I do.
Right arm is 120/65.

Why the difference in each arm. I take it various times a day while sitting down. I know my BP monitor is accurate. Do I have high blood pressure? which arm do you go off of?
Thanks in advance.
 Dr. Tamer Fouad - Mon Jul 14, 2003 5:47 pm

User avatar Dear Oubeta,
An acceptable inter-arm systolic blood pressure difference is 10mmHg. The difference in your case seems to exceed that.
I would suggest before delving into the causes of this condition to have a doctor examine your blood pressure. Note that you should be rested for 5 minutes before the reading and that you should use an appropriate sized cuff.
If a doctor does indeed conclude the blood pressure difference is high (he may need to confirm this with a doppler), an underlying condition should be sought. Congenital conditions in the differential diagnosis include aortic coarctation and thinning of 1 of the subclavian, axillary, or brachial arteries. Acquired arterial conditions include aortic dissection, atheroma, thrombus, embolus, and extrinsic compression (as might be seen in association with a mass in the upper chest).

In this case you should have a contrast-enhanced CT of the chest to effectively delineate among the possibilities mentioned above. A vascular ultrasound would be helpful as well, but the CT would better show an extrinsic compression.

Best regards.
 OUBETA - Mon Jul 14, 2003 7:59 pm

I also have a kink or murmur in one of my valves. I had it checked out when I ws a kid and they said is 'shouldn't' give me any problems. I had a follow up about 4 years ago.
Could a kink have something to do with this?

Also 6 weeks ago I finished a cycle of testoserone at 500mg per week for 8 weeks. I also took 5000 IU's of HCG after and an anti-estrogen Nolvadex. I had blood work done before and after and all my levels are back to normal. My free test is still a tad low. Would this have anything to do with my high BP? Would it be a bad idea to start another if my liver values and everything are normal?
 Dr. Tamer Fouad - Tue Jul 15, 2003 1:23 am

User avatar Yes coarctation of the aorta can lead to a disparity in blood pressure readings. I don't think you should start on a heavy training course until you have been checked out.
 OUBETA - Tue Jul 15, 2003 12:45 pm

Thanks for the help guys. Do know what the cuff size of the Docs BP taker? My arms are 20 inches and most are about 15 I think. I had to order a special cuff to check mine.
One other thing. When it pumps up to take my BP on my left arm it has to pressure way up to 240mmHg to get a reading. On the right it only has to pressure up to 160mmHg. DOn't know if this would tell you anything.
 OUBETA - Wed Jul 16, 2003 9:53 am

I had it checked this morning. There was the same difference between arms. He wants me to come back 2 more times for readings. I told him I take it 7 times I day and I know what the readings are. He told me they had to take them. I think I do a better job than hi PA. Anyway I asked him about the difference in each arm and his answer was,,,well your muscle might be bigger in your left arm. Time for a new doc?

He wants to put me on BP meds if it is high on the next 2 visits. Shold I go to a cardio doc to see exactly there is that BIG of difference in arms?
thanks again
 OUBETA - Wed Jul 16, 2003 1:59 pm

Aortic Coarctation from my research seems to be the culprit. I need to review my medical records, but I know I have a kink in one of my valves. I don't know which one.
 Dr. Tamer Fouad - Thu Jul 17, 2003 7:33 am

User avatar No I don't think you should take anti hypertensives before looking for a cause. Yes you may need to consult with another doc. A cardiologist would be best. His claim that one arm is bigger than the other might not be entirely false I am just not in a position to judge on that.

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