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Avatar universal

Different blood pressure reading on left and right arm

Since a little while I notice that my blood pressure reading on left arm is way higher than on the right arm (I'm right handedness).

I always feel my pulse very strong and loud on my left side (take it on my wrist but also the big vein on my neck) but not on my right side and I have also left side chest pain often but all the time at rest and never if I do something physically. I had a mibi scan recently (nuclear stress test cause I can't walk on a treadmill because I'm physically to weak) but didn't receive my results yet, almost 1 1/2 months later and still waiting. I guess if I had something wrong with my heart, the cardiologist will have call already?

Im on a beta blocker med call metoprolol (regular not slow release) and take 75 mg day divided in 3 doses of 25 mg. it help sometimes to lower my heart rate who is the reason why my cardiologist RX it in the first place but I feel like crap on that med (and all the other beta blockers I tried so far).

I have exercise intolerance, severe anxiety and have intestinal problems so can't eat normally (survive on liquid supplement). I'm not underweight but not overweight too, my weight is 170 pounds and my height is 6 feet tail. Last blood tests was ok (complete fasting blood tests for all the vitamims, minerals, lipid profile (low LDH and triglyceride but also very low good cholesterol HDL level), also no anemia, high vitamin B12 and high folic acid, mid range vitamin D, calcium and potassium are normal, Very low HS Protein C reactive and very low APO-B but also very low APO-A (who is a bad thing).

Anyway, usually, my blood pressure on the lest arm at rest is on an average of 115/75 and pulse rate of 65 sit and 90-130 just standing (suspect dysautonomia but no test for that diagnosis where I live). On the right arm, my average blood pressure will be around 105/60 and the pulse rate is the same as the left side.

So the difference between the left and right arm systolic is around 10 and for the diastolic is about 15... I'm a lot worried about it and my last echo show nothing wrong with my valves or ejection fraction BUT no cardiologist took my blood pressure on both arm, seem like it's not very important for the cardiologists where I live...

Should I stop worried about the big difference between each arm for the blood pressure? Should I ask for more tests? And what about the big difference for the diastolic number on each arm? Seem like the beta blocker only reduce my systolic blood pressure but will not touch at all the diastolic. Sometimes I will have weird reading of 100/80 on the right arm and the difference of 20 who is call the pulse pressure is very low.

Any kind of help will be appreciate.

Thank you.
2 Responses
11548417 tn?1506084164
It has nothing to do with your valves or EF. Your heart has only one output to supply the whole body (left and right) with oxygen rich blood. Further down the line this supply splits in left and right sideways, upside and downside etc to supply all organs in the body. As you have only one heart output, it is inevitable that the pulse rate is identical in left and right arm.

Arteries have only limited diameter which gives resistance to the blood flow and therefore the blood pressure is lower at the end of an artery than at the beginning. When arteries are thinner, the drop of blood pressure is bigger.

A difference in bp from left to right means that there is a difference in vessel resistance between the two sides.

This can have different causes.
-If you, for instance, use one of your arms a lot more than the other, blood demand will be higher in that arm and that will eventually lead to a higher blood supply in that arm because arteries will get bigger. This will cause a lower blood pressure in that arm, compared to the other.
-If blood supply in one arm is impaired through plague that is partially blocking the blood flow further down the arm, it will increase the blood pressure measured in that arm.

A lot of people have different bp reading for left and right, although a difference of 15-20 is quite a lot.
Avatar universal
Hi, thanks for your answer. It explain very well what can be the problem (if I have a problem of course).

For the pulse rate, I know it's the same on each side, it's logical and I never mean that it was different. My problem is the difference between each arm blood pressure.

I use more my left arm especially when I need to strain or hold on Something very big, so with your explanations that's mean that i'm suppose to have a lower blood pressure on the left arm since I use it more often? So why I have higher blood pressure reading on the left arm and lower on the right side?

For the plaque it's a normal process as we age. We all have some plaque in the arteries, some factors can contribute to more plaque and increase chance to have a heart attack or a blockage if you smoke (I smoke since 27 years 1 pack a day and try to quit often but it's very hard especially when you have a lot of anxiety). Poor healthy diet can also lead to more plaque as well as a lack of physical exercise.

Do you think that when I take my blood pressure first on the left arm, it will lower the blood pressure on the right arm especially if I don't wai't and take it 30 seconds later on the right arm?

Also, when I take a second reading after 1 minute on both arm, the blood pressure reading on both arm will be a lot lower about 10 for the systolic and 5 for the diastolic. Is it normal?

Last question, I just took my blood pressure and on the left side it was 116/69 and on the right arm it was 106/61, for me it's seem a lot and I never had that before and both arms had almost the same blood pressure with little difference especially for the diastolic. What can explain that my diastolic is so high on the left arm and lower on the left arm? I mean the diastolic blood pressure is when the heart relax between 2 heartbeat so what can affect the diastolic blood pressure so much on my left arm?

My doctor told me that the youger you are and the higher is the diastolic blood pressure and to not worry about it, he said also that as you get older the diastolic tend to be lower and systolic higher. I'm really not happy about the big difference between each arm for the blood pressure because I didn't had that problem in the past and nothing change in my life to explain that recently.

I read some studies about the increase risk of heart attack or blockage in people who have a 10 points difference and more in the systolic blood pressure reading between the left and right arms. So i'm worried a lot. I also read that having higher diastolic blood pressure cause less damage than high systolic blood pressure but don't remember why.

Anyway thanks for your help. I will ask the Cardiologist about my concerns next time I see him.
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