Journals of Gerontology Series A: Biological Sciences and Medical Sciences, Vol 50, Issue 1 M56-M58, Copyright © 1995 by The Gerontological Society of America
Arterial closing pressure correlates with diastolic pseudohypertension in the elderly
M Mac Mahon, NF Sheahan, MP Colgan, B Walsh, J Malone and D Coakley
Mercer's Institute for Research on Aging, St. James' Hospital and Trinity College, Dublin, Ireland.
BACKGROUND. Pseudohypertension has frequently been reported in the elderly
population, with the diastolic measurement being the most frequent source
of error. There is no satisfactory noninvasive method of calculating the
error in the blood pressure reading. We investigated the role of arterial
closing pressure in the diagnosis of diastolic pseudohypertension. METHODS.
Indirect and direct blood pressure were measured in 24 elderly patients.
Brachial artery closure was visualized by ultrasound in all subjects.
Arterial closing pressure (ACP) was recorded as zero if the vessel was seen
to close spontaneously when it was isolated from central arterial pressure.
If the vessel did not close spontaneously, a water cuff was applied
externally over the artery and the additional pressure required to close it
was recorded. RESULTS. Diastolic pseudohypertension was noted in 8
subjects. Spontaneous closure of the brachial artery occurred in the 16
without pseudohypertension; i.e., ACP = 0. Additional pressure of the water
cuff (range: 30-158 mm Hg) was required to collapse the artery (ACP) in
those with diastolic pseudohypertension. ACP correlated with the extent of
diastolic pseudohypertension (range: 5-17 mm Hg); r = .85, p < .001).
CONCLUSION. We propose that ACP may be used to diagnose the presence and
extent of pseudohypertension.
