big differences in bp in left arm to right arm

[Yorkie - UK]

Can you help with this mystery please as my doctor has not seen this before?
i am being treated with adalat la 30 which of course is nifedine for high bp diagnosed when i was 40 years.but i stopped taking medication then due to personal reasons (my fist wife died).i had been checked at that time by vasuclar surgeon&also a cardiologist,&was admitted to hospital for severe high bp by my family doctor.it was the hospital put me on adalat in 1989.i had disc surgery in 1982 &further pain surgery some 19 times subsequent years incuding epidural etc.
bp in left arm varies 202 to 149 over 116 to 83
bp in  right arm varies  149 to120 over 102 to 86
i have palpitations some times of day/night.
i am male 59 years 6.0ft 89 kilos non smoker 9 months .non drinker 20 years ,&eat very healthily no processed food  &low carb food/low fat.i was diagnosed with copd 4 years ago&emphesema.i do aerobic &weight training at least 4 days a week for 1 hour each session .my fev 1 a year was 216 now 170 but i am recovering from numerous cosecutive infection since february 2007 all trated with care of family doctor prescribed antibiotic (various).
CAN YOU PLEASE HELP WITH THIS DILEMMA AS NOTHING ON INTERET RE SUCH BIG DIFFERENCES.i am right handed.

[Yorkie - UK]

Dear Dr  Conaway,thankyou you very much  for your help it was much appreciated.my family  doctor is referring me to a cardiologist in the near future which will probably be in the new year
and yes my question was about quite large differences in bp in left compared to right as my family doctor says i should see a cardiologist.he noted on physical examination that my pulse was lagging behind on was side of body to other..many many thanks stuart

[Darcy Green Conaway, MD]

I want to make sure I understand your question-- it sounds like you are concerned about the blood pressure difference between the left and right arm? There are certain things known to cause a higher blood pressure in one arm, such as coarctation of the aorta (a narrowing of the aorta). Given that you are now over 40 years old I doubt that is the case. It may be that you a vascular abnormality on one side. If your physician is worried about a possible coarcation, a CT angiogram can be done. You could consider an angiogram of the major vessels taking off from the aorta as well, although if you are asymptomatic I am not sure I would recommend an invasive procedure. Please discuss the findings with your cardiologist and/or vascular surgeon.