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High Blood Pressure

Severe high blood pressure in legs

05/13/2009

Question:

I asked this question yesterday...but typed in the wrong numbers for my blood pressure.

What are some possible causes of high blood pressure in the legs? My upper arm pressure was 150/95 (NOT 15/95 like I incorrectly typed yesterday). But my middle calf blood pressure was 210/118. Also, how is high blood pressure treated? Thank you.

Answer:

It is normal for the blood pressure to be slightly higher in the legs than in the arms.  The difference is usually only a few points.  However, in patients with arterial stiffness ("hardening of the arteries"), usually older persons, the difference can be greater.  This is due to the pulse wave that travels down the arteries.  If the arteries are stiff, the pressure wave can be augmented.  There is reflection of pressure waves from several points along the arteries.

The treatment of high blood pressure should be based on the pressure in the arms.  A blood pressure of 120/80 is normal, and any blood pressure above 140/90 should be treated.  Treatment almost always involves medication.  Many physicians prefer to start a patient on an ACE inhibitor (e.g. lisinopril) or a diuretic (e.g. hydrochlorothiazide).  If one drug is not enough or reach goal blood pressure, a second drug and possibly a third one can be added.

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Response by:

Max C Reif, MD Max C Reif, MD
Professor of Medicine
Director of Hypertension Section
College of Medicine
University of Cincinnati