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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