why is my blood pressure higher in my left arm
Part of the reason the left arm is preferred is because it is closer to the heart; also, it is part of standardization. If you are wanting to see changes in your BP over time, then you want to measure it the same way (same time of day as well) each time. One reason to look at BP in both arms is to look for large differences that might be indicative of some sort of circulatory issue. Within a minute or so, the restrictive forces in re-taking a BP would be gone and you would could get a similar reading. The real concern with most BP units of the manual type are calibration and operator error. The calibration can be way, way off and it is really impossible to tell without checking it against some standard. I disagree that at rest a trained person's systolic pressure would be higher. This really goes against a reason for people to exercise (that is to lower BP). In fact, a trained person might have a lower systolic because the blood vessels are not going to be as restrictive to the flow of the blood. I am not sure how many BP measures 123 has done, but systolic pressure during exercise can be very, very high. At a high HR, the venous return is still very high. While the LV might not be filling completely the rate is such that the time between beats is very small so the pressure remains high and near constant. Diastolic pressure will decrease or stay the same (rarely rise) because of vasodilation from other factors at work on the smooth muscle of the vessels. Some people do look more closely at diastolic pressure in terms of CV disease for some of the reason you note.
Also a t rest (which is where we spend 22+ hours of the day) your diastolic pressure is the pressure exerted on the artery walls 2/3 of the time. In some ways that is more strain than the occasional pulse of high pressure blood coming by. As for the penis issue, blood flow is restricted to the penis most of the time. Not really sure that this has to do with the issue at hand other than some BP meds create erectile dysfunction and it seems like many of the posters here think with their dicks.
One investigator (CEC) gathered all the data. In designing this study, a sequential method of measurement was chosen as a pragmatic test within the consultation. A recent meta-analysis has suggested that a simultaneous, automated repeated measurement method with one or two machines should be the ideal for epidemiological study, and we also, subsequent to establishing this study, showed that a simultaneous measurement technique reduces bias. Studies relevant to the general population using such techniques have reported lower prevalences of an interarm difference in blood pressure than those using sequential measurements. However, subsequent sampling of the study cohort presented here, using a robust simultaneous measurement technique, showed similar prevalence rates for interarm differences of 10 mm Hg or more of 19% for systolic blood pressure and 7% for diastolic blood pressure (compared with the 23% and 6% reported here). One study also reported a strong correlation of interarm differences when comparing three simultaneous and three sequentially gathered pairs of readings, and a correlation remained when measurements were repeated at a later date.
We have presented data suggesting that a single sequential pair of measurements can reliably rule out an interarm difference in blood pressure with high negative predictive value, and our new meta-analysis has shown no difference in the strength of association between peripheral vascular disease and systolic interarm differences in blood pressure according to the method of measurement. Given current knowledge, if designing this study now we would adopt an automated simultaneous measurement method, although we believe that our pragmatic approach remains relevant to Бreal worldБ practice. The lack of strict randomisation of the order of arm measurement could have introduced bias, as blood pressure measurements will often decrease during repetition. No strict first arm preference was adopted, however, and the small absolute difference in blood pressure in favour of right or left arms is in keeping with previously reported large series and suggests that no systematic bias was introduced. The investigator CEC was not blinded to data collection, but because events were recorded prospectively over 10 years, and our definitions of non-fatal events required independent diagnosis in secondary care, we do not believe that this lack of blinding could have biased the survival outcomes reported. We did not collect data on drug use at recruitment or changes in use during the study period, so cannot comment on potential survival differences due to drugs.
This is a small study from one rural general practice. The reported prevalence of participants receiving treatment for hypertension in this study was 14. 3% of the list, comparable to the 13. 7% for women and 11. 7% for men reported at the time by the health survey for England. Therefore we believe that these findings can be generalised to other similar cohorts of people with hypertension being treated in primary care, although the lack of representation of ethnic minority groups in Devon is a recognised limitation. Conversely, this rural practice has a low turnover of patients, facilitating long term follow-up, which we see as a strength. Based on the previous analysis of this cohort, giving a hazard ratio of 2. 5 for the composite outcome of mortality or event at a cut-off point for interarm difference in systolic blood pressure of 10 mm Hg, we estimated that we would have required a total of 50 observed events to achieve 90% power and 62 to achieve 95% power. In this follow-up we observed 108 deaths or events. Higher cut-off values were initially included in the analysis plan to permit comparison with other survival studies ; however, the diminishing numbers of participants with an interarm difference in systolic blood pressure of more than 15 mm Hg meant a reduced precision of the event results for higher interarm differences, these analyses are therefore not included in the data presented.
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