Question: What is Pseudohypertension?
Answer: Pseudohypertension is when blood pressure measurements are elevated but the blood pressure is actually normal.
Pseudohypertension is not very common, and it is almost always found in older patients. As people get older, the walls of the arteries sometimes get very thick, and calcium may be deposited in the arterial wall. This makes the arteries very stiff and difficult to compress.
Because measuring blood pressure depends on measuring how much force it takes to compress an artery, having thick, difficul-to-compress arteries falsely elevates the sphygmomanometer reading.
Doctors usually suspect pseudohypertension in cases where:
- The blood pressure reading is very high over time, but the patient has no signs of organ damage or other complications
- Attempting to treat the measured high blood pressure causes symptoms of low blood pressure (dizziness, confusion, decreased urine output)
While a finger blood pressure meter or other similar devices may provide some useful data in cases of suspected pseudohypertension, the only way to confirm the diagnosis is by directly measuring the intraarterial blood pressure. This is done inserting a needle directly into a small artery.
Previously, a noninvasive technique called Osler's maneuver was used instead of direct intraarterial measurement. However, data has shown that this technique produces poor results, and its use today is inappropriate.
Sources:
1. Zweifler, AJ, Shahab, ST. Pseudohypertension: A New Assessment. Journal of Hypertension, 11(1).
2. Tsapatsaris, NP, et al. Osler's Maneuver in an Outpatient Clinic Setting. Archives of Internal Medicine, 151(11): 2209-11.
