Pseudohypertension: An update

J. R. Oster, B. J. Materson

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Pseudohypertension is a specific type of artifactual hypertension almost always occurring in the elderly. In this condition, the indirectly measured intra-arterial pressure determined with a sphygmomanometer is much higher than the directly measured intra-arterial pressure; this results from medial calcification of arteries (usually Monckeberg's calcinosis), which markedly decreases their collapsibility. If unrecognized, pseudohypertension may result in unwarranted and sometimes dangerous treatment. Both the systolic and diastolic pressures may be affected. Available data suggest that pseudohypertension is uncommon in unselected patients, but its true prevalence is unknown. Very high blood pressure in the absence of appreciable target organ impairment is an important clue. Radiographs of the soft tissues of the arms of patients with pseudohypertension generally reveal diffuse vascular calcification. Osler's maneuver (the attempt to palpate a radial or brachial artery made pulseless by proximal compression) has not proven to be a clinically valuable screening test for pseudohypertension. Blood pressure values obtained by electronic oscillometry may more closely approximate intra-arterial DBP. The definitive diagnosis of pseudohypertension still requires an invasive procedure: comparing the intra-arterial pressure with the indirectly determined blood pressure.

Original languageEnglish (US)
Pages (from-to)112-120
Number of pages9
JournalCardiovascular Risk Factors
Volume2
Issue number2
StatePublished - Jan 1 1992

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Oster, J. R., & Materson, B. J. (1992). Pseudohypertension: An update. Cardiovascular Risk Factors, 2(2), 112-120.