The Test for Heart Disease Your Doc May Be Doing Wrong
What usually happens: You come racing into the doctor's office, narrowly avoiding being late (and being forced to wait for three hours while the staff rearranges the schedule). The clinician immediately brings you into an office and slips on the blood pressure cuff while firing questions at you. She pumps the air bulb (squeeze, squeeze, squeeze), pauses, takes a reading and then removes the cuff and preps you for the next test.
What to make happen: First, relax. We know, it's easier said than done, but hustling to the office inadvertently boosts your reading: Walking briskly can add 5 to 14 points, while driving in traffic could raise it 9 to 14 points. When you arrive, ask for five minutes to breathe and use the bathroom (a full bladder can tack on another 20 points).
Next, make sure you get a reading for both arms. Many doctors will do this as a double-check for accuracy. But a new study shows that this not only a good idea; it's actually a necessary test that stands on its own. A difference of just 10 points between the two readings could suggest an increase of up to 38 percent in your risk for a cardiac event, found research published in The American Journal of Medicine. The study, run by Harvard University cardiac experts, involved analyzing data from a long-term heart study and followed 3,390 people aged 40 or over. Of the 598 people who had a cardiac problem, more than a quarter had a 10-point difference in their systolic blood pressure readings (the "upper number," measured in millimeters of mercury). This kind of difference may mean that over time you might have an elevated chance of a clogged artery or blockage in the leg, which could lead to an ulcer, stroke, heart attack, or even an amputation, says Ido Weinberg, MD, a vascular medicine specialist at Massachusetts General Hospital and one of the study's authors. Even if your clinician is already taking readings in both arms, he or she may not realize what the difference signifies, Weinberg says. It's a red flag—but one you can act on if you know about it.