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About The Siuslaw news. (Florence, Lane County, Or.) 1960-current | View Entire Issue (June 25, 2016)
4 B SIUSLAW NEWS ❚ SATURDAY, JUNE 25, 2016 TO YOUR GOOD HEALTH Why blood pressure readings can vary DEAR DR. ROACH: I would like to comment on your column regarding blood-pressure differences between the arms. A difference of greater than 10 mmHg between the two arms in sys- tolic pressure is considered abnormal. We see patients not uncommonly in consultation for this reason alone, per- haps as many as one a month. Almost always, the reason for the difference is blockage of the subclavian artery. The wrist pulse on the side with lower blood pressure may be normal, dimin- ished or absent in those patients. From 30 years of observation, I have noticed that patients with BP dif- ferences between the arms are nearly always female smokers (or former smokers), and the left subclavian is much more likely to be affected (have a lower blood pressure) than the right. SALOME’S STARS ARIES (March 21 to April 19) You clever Ewes and Rams love nothing more than to rise to a challenge. So, by all means, if you feel sure about your facts, step right up and defend your side of the issue. TAURUS (April 20 to May 20) You’ve done some great work recently. Now it’s time to reward yourself with something wonderful, perhaps a day at a spa or a night out with someone very special. GEMINI (May 21 to June 20) You love to talk, but don’t forget to make time to do a little more listening; other- wise, you could miss out on an impor- tant message someone might be trying to send to you. CANCER (June 21 to July 22) Your aspect indicates some uncertainty about Why this sex difference should be and why the left side should predominate is not understood and, to my knowl- edge, has not been described in print. Additionally, the presentation is usual- ly in a non-obese woman in her 40s or 50s who is still smoking. The significance of the finding is that it is a red flag waving for tobacco cessation and is a marker that that per- son’s arteries have already been signif- icantly altered by the habit. Fortunately, the incidence of arm symptoms associated with the lower BP on that side is quite low — perhaps 1 in 10 have any symptoms. It is important, of course, for such patients to be aware of the difference between the arms only to remember which arm (the higher arm systolic number) has the correct measurement (most often, but not always, the right). — Jerry Svoboda, MD, FACS ANSWER: I thank Dr. Svoboda for his expertise and will add difference in arm blood pressures to my (already very long list) of reasons to quit smok- ing immediately. DEAR DR. ROACH: I’ve heard many medical providers say that they believe they get more accurate blood pressure readings from the old-fash- ioned manual method, rather than the automatic cuff machines. I wonder how true this can be, though, since the former is subject to human hearing ability. My excellent hearing lets me pick up on beats far beyond what someone who has average hearing can detect, so it stands to reason that there would be a difference in the reading. — C.B. ANSWER: The very best machines are accurate at measuring blood pres- sure; however, a trained clinician remains the standard for blood pres- sure measurement. Fortunately, good, but not necessarily outstanding, hear- ing is required for accurate blood pres- sure measurement. Proper placement and inflation of the cuff, the correct slow deflation rate and, importantly, measuring both arms are as significant as good hearing. I was taught to take an average of three measurements. Excellent hearing helps the clinician pick up on subtle heart murmurs and other noises, normal and abnormal, that the heart makes. If you decide to become a physician, consider cardiol- ogy. We physicians should take great care to protect our ears; sadly, some of us listened to music that was too loud at some points in our lives. one of your goals. Use this period of shifting attitudes to reassess what you really want and what you’re ready to do to get it. LEO (July 23 to August 22) Your social life is picking up, and you’ll soon be mingling with old friends and mak- ing new ones. But ‘twixt the fun times, stay on top of changing workplace con- ditions. VIRGO (August 23 September 22) A trusted friend offers understanding as you vent some long-pent-up feelings. Now, move on from there and start making the changes you’ve put off all this time. LIBRA (September 23 to October 22) You might well feel uneasy as you face a difficult situation involving someone close to you. But you know you’re doing the right thing, so stick with your decision. SCORPIO (October 23 to November 21) You’re a good friend to others. Now’s the time to allow them to be good friends to you. Rely on their trust- ed advice to help you get through an uncertain period. SAGITTARIUS (November 22 to December 21) Family and friends are always important, but especially so at this time. Despite your hectic work- place schedule, make a real effort to include them in your life. CAPRICORN (December 22 to January 19) That project you’ve been working on is almost ready for presen- tation. But you still need some informa- tion from a colleague before you can consider it done. AQUARIUS (January 20 to February 18) Don’t let those negative attitudes that have sprung up around you drain your energies. Shrug them off, and move ahead with the confi- dence that you can get the job done. PISCES (February 19 to March 20) Aspects favor some dedicated fun time for the hardworking Piscean. A nice, refreshing plunge into the social swim can recharge your physical and emo- tional batteries. Siuslaw N ews ! 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