Blood pressure measurement

[runnertom]

Hello and thanks for entertaining my question.
I am a 58 yo male who had CABG 4 years ago due to an LAD blockage at the bifurcation. I had what I thought was a very good risk profile with LDL/HDL of 130/60, normal BP, and a 30 year history of competitive running and cycling. Family history fairly benign. In trying to find the "smoking gun", why I had a blockage, I considered exercise induced hypertension that I was aware of (via a treadmill) considering the 10 to 15 hours of strenuous training I maintained. I also found that blood pressure taken at my ankle was 10 to 20 points higher than that at the arm. I wondered whether I was being fooled by a low arm reading and I was really hypertensive the whole time. More recently, I was diagnosed with left ventricular hypertrophy (vent wall and septum 15 mm)with still normal blood pressure. 6 months of 5mg lisinopril and 3 mo of 25 mg Toprol for atrial fib caused it regress to 11 mm. I have had no further problems with Afib for the last several months either although that may be due to the magnesium supplements I have been taking.
I have read some recent medical journal articles talking about the difficulty of finding the true aortic blood pressure with the normal arm cuff. Is it possible that has been my problem all along? I don't seem to have any problem in daily life with the arm measured bp of 95/55.

[CCF-M.D.-MJM]

Hi Tom,

Number one, keep up the exercise.

I also found that blood pressure taken at my ankle was 10 to 20 points higher than that at the arm.

It is expected that the blood pressure in the legs be higher than blood pressure in the arms.  This is a common medical school exam question.


Is it possible that has been my problem all along (under measurement of aortic pressure?

We occassionally see this in our lab -- cuff pressure that don't much the aortic pressure.  It is not common.  It is unlikely that this is your problem, but I cannot tell you for sure.

I hope this answers  your questions. Keep running and thanks for posting.

[runnertom]

I forgot to expand on my echos. I had serial echos over four years that showed the vent wall and septum starting at 11 mm at first and steadily marching up to the 15 mm 6 months ago.

[Flycaster305]

That's an interesting question, I'm anxious to hear the doctor's response. My BP readings are always ten points higher when taken on the left arm as apposed to the right side.