Controlling Your Blood Pressure Archive

Ask the doctor

Q. Why are the blood pressure readings in my right and left arm different even when they're taken within a minute or two of each other?

A. The answer depends on how big of a difference you're talking about. A difference of just a few points (that is, a few millimeters of mercury, or mm Hg) is nothing to worry about. It's actually quite normal, even when both arms are checked almost simultaneously.

Here's what you need to know about the discovery of contaminants in a popular class of heart medications.

Last summer, a number of prescription medications containing the generic drug valsartan were recalled by manufacturers after investigators found trace amounts of possible cancer-causing impurities in some of the products. Over the following months, additional lots of valsartan, as well as batches of two similar drugs, losartan and irbesartan, were also pulled from pharmacy shelves.

All three of these drugs belong to a class of medications known as angiotensin-receptor blockers, or ARBs. These drugs block the effects of a hormone that narrows blood vessels and are used to treat high blood pressure and heart failure. The recalled products also include combination drugs that contain one of those three ARBs. (See "Medication recall information" for accessing the list of affected products.)

On call

Q. I know that erectile dysfunction can be a common side effect of blood pressure medications, but can they also lower my sex drive?

A. Sexual issues are a side effect of many medications, including ones prescribed to lower blood pressure. You're correct that erectile dysfunction (ED) is mentioned most frequently. But blood pressure medicines also can decrease sexual drive or make it more difficult to reach orgasm.

On call

Q. After I have a bowel movement I sometimes get quite weak and have to lie down until the feeling passes. Why does this happen and is it cause for concern?

A. The sensation you are describing is most likely due to a reflex called a "vasovagal reaction." Here's what I mean.

Q. I have rheumatoid arthritis, and my doctor wants me to take prednisone for it. Will prednisone be bad for my blood pressure, which is already high?

A. Prednisone raises blood pressure in many people who take it. One reason is that prednisone and other corticosteroids cause the body to retain fluid. Extra fluid in the circulation can cause an increase in blood pressure.

It might be orthostatic hypotension, a condition that can be challenging to catch and treat.

You stand up and suddenly feel unsteady on your feet. It's easy to brush off this experience as a fluke or a bug, but don't. You may have a condition called orthostatic hypotension, a temporary drop in blood pressure when you stand. It's tricky to catch.

"Blood pressure is highly variable, and depends on position, timing, the method of measurement, and circumstances associated with its measurement," says Dr. Lewis Lipsitz, chief of gerontology at Harvard-affiliated Beth Israel Deaconess Medical Center and director of the Marcus Institute for Aging Research at Hebrew SeniorLife. "It may take multiple blood pressure measurements at different times of day, lying and standing, in order to detect orthostatic hypotension," Dr. Lipsitz says.

What the latest science says about caffeine's influence on your heart, memory, sex life, and exercise performance.

Americans are jolted with caffeine. On average, about 80% of adults take some form of caffeine every day, according to the FDA, usually from coffee, tea, soda, or energy drinks.

But does all that caffeine have any effect on your health — either good or bad? "While caffeine can give you a temporary mental and physical boost, its impact depends on how much you consume and the source," says Dr. Stephen Juraschek, an internal medicine specialist at Harvard-affiliated Beth Israel Deaconess Medical Center.

Dealing with the emotional effects from a physical setback can be a challenge. These three strategies can help.

The physical repercussions of a major health issue, like surgery, an injury, or a heart attack, are tough enough without having to also confront the stress, anxiety, and depression that often accompanies it. Yet managing your mental health is just as important as your physical health when it comes to making a full recovery.

"There is no question that your state of mind can dictate how quickly you can return from a physical setback," says Dr. Jeff Huffman, director of the cardiac psychiatry research program at Harvard-affiliated Massachusetts General Hospital.

The benefits of meditation go beyond stress reduction.

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Most of us sense instinctively that clutter is unhealthy. Sure, we may joke about a disorganized desk or a teenager's messy room, but we feel that a clean, organized space is a healthier, more soothing environment. What about a cluttered mind — a mind constantly presented with different simultaneous challenges and distractions? Is that unhealthy, and is there a fix?

Uncluttering — or, as is usually said, "emptying" — your mind through meditation has a host of health-related benefits, and maybe that's why more people are taking up the practice. Data from a national survey conducted by the CDC's National Center for Health Statistics, published online by the CDC in November 2018, found that 14% of American adults reported meditating in 2017, compared with just 4% in 2012.

People with fluctuating numbers — like blood pressure, cholesterol, and weight — may be at higher risk of heart attack, stroke, and even death.

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Most people battle "yo-yoing" at some point, when their weight, blood pressure, or some other health number keeps going up and down.

On the surface, this may not seem like a problem if you routinely hit the healthy numbers. Yet new research suggests that fluctuations like this may pose a greater health risk than staying at a single level, even if it's not a perfect one.