- With Mayo Clinic emeritus hypertension specialist
Sheldon G. Sheps, M.D.
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Sheldon G. Sheps, M.D.
Sheldon G. Sheps, M.D.
Dr. Sheldon Sheps, emeritus professor of medicine and former chair of the Hypertension Division in the Department of Medicine at Mayo Clinic, has been with Mayo Clinic since 1960.
Dr. Sheps, a Winnipeg, Manitoba, native, is board certified in internal medicine and specializes in hypertension and peripheral vascular diseases. He developed a multidisciplinary approach with specially trained nurses, dietitians, technicians and educators to help form a team approach to the treatment of patients with abnormal blood pressure.
"I have always believed in involving the patient and family in their health care," he says. "I have asked for their understanding of the illness and issues and for participation in decisions. The Web is a natural extension of that, and now many more people can be informed."
Dr. Sheps chaired the sixth working group, and participated in the fourth, fifth and seventh groups, that developed the then-latest guidelines for hypertension under the auspices of the National Heart, Lung and Blood Institute (NHLBI). He helped write the latest American Heart Association (AHA) report on blood pressure measurement. He chaired an AHA group that produced an online accreditation for blood pressure measurement for health professionals. He has co-authored books, newsletters, CD-ROMs and other Mayo Clinic health information material and joined Mayo Clinic's Web team in 1998. He was medical editor-in-chief of both editions of the "Mayo Clinic on High Blood Pressure" book; the last edition was published in 2003. He was also medical editor-in-chief of "Mayo Clinic 5 Steps to Controlling High Blood Pressure,'' published in 2008.
He was section editor for each of the first three editions of "Hypertension Primer" for the American Heart Association.
Dr. Sheps was also chairman of the Science Base Subcommittee, National High Blood Pressure Education Program, and was a consultant to the Hypertension Initiative of the World Health Organization. In 1997, he was honored with the Individual Achievement Award on the 25th anniversary of the National High Blood Pressure Education Program of NHLBI. In 2009, he was honored as a Distinguished Mayo Alumnus.
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Question
Blood pressure: Can it be higher in one arm?
When I measure my blood pressure at home, I've noticed that the reading is always higher in one arm. Should I be concerned?
Answer
from Sheldon G. Sheps, M.D.
Generally, a small difference in blood pressure readings between arms isn't a health concern.
Blood pressure readings are given in two numbers. The top number is the maximum pressure your heart exerts while beating (systolic pressure), and the bottom number is the amount of pressure in your arteries between beats (diastolic pressure). A difference of less than 5 millimeters of mercury (mm Hg) between arms for either reading is normal. However, a difference of more than 20 mm Hg for systolic pressure or more than 10 mm Hg for diastolic pressure may be a sign of an underlying problem — such as narrowing of the main arteries to that arm. If you have a significant difference in blood pressure readings between arms, consult your doctor for an evaluation.
Remember, many factors affect blood pressure. To detect a difference in blood pressure between arms, your doctor may take a series of alternate-arm blood pressure readings. He or she may also measure your blood pressure in both arms at the same time with two blood pressure gauges and two observers.
If your blood pressure is higher in one arm, your doctor will probably use the blood pressure reading from that arm to monitor your blood pressure.
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