Blood Pressure Measurement in the Elderly: Correlation of Arterial Stiffness with Difference Between Intra-arterial and Cuff Pressures

Pseudo-hypertension in the elderly: still hazy, after all these years

“…How common is pseudohyand 12 + 5.8 mm Hg in the OM − . They found, as did pertension, and how can it be reliably detected short we 4 and Messerli et al, 2 that there was a good correof doing intra-arterial BP measurements? It is interlation between the pulse wave velocity and the magesting that these issues remain unresolved, after 20 nitude of cuff artifact.…”

“…thy elderly subjects, 4 and our finding 15 that an automated digital device using an oscillometric method Subsequently, others have defined pseudohypertension as a false elevation of the pressure by cuff more accurately predicted increased left ventricular mass over 2 years of untreated borderline hypertenmeasurement of 10 mm Hg or more; that way of looking at things is problematic because systolic and sion than did random zero pressures, all suggest that in the elderly, pressures may be more accurately diastolic pressures, somewhat surprisingly, have errors in cuff measure that are usually opposite in measured by automated oscillometric devices than by auscultation. sign or direction; the systolic pressure is usually falsely reduced by the cuff.…”

Pseudohypertension and the measurement of blood pressure.

“…8 - 20 In groups A, B, and C we determined separately in another session the volume changes beneath a slowly deflating cuff around the forearm, using electrical impedance plethysmography, as described by Gizdulich and Wesseling. 32 Arterial transmural pressure was calculated by subtracting finger mean arterial pressure measured contralaterally by the Finapres 27 from the pressure in the cuff placed uver the sensing electrodes of the plethysmograph.…”

“…However, no correlation could be observed between blood pressure levels and RRK-IAP differences. Furthermore, a relation between vascular rigidity and RRK-IAP differences has both been described, 8 ' 20 and denied. 10 Using a different measure for vascular rigidity, 32 we could not confirm such a correlation in the present study.…”

“…5 ' 6 However, many factors may cause erroneous RRK measurements. 7 Concerns have, for example, been raised about the reliability of RRK measurements in patients with Monckebergs medial calcifications, in whom pseudohypertension, defined as any RRK-IAP difference exceeding 10 mm Hg, 8 -10 may occur because the brachial artery cannot be compressed. 11 However, pseudohypertension has not only been described in patients with extreme calcifications of the brachial artery, but also in varying numbers in healthy, hypertensive, and elderly populations.…”