Screening for Pseudohypertension

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Abstract
• We studied 36 hypertensive men, aged 60 years or older, and compared direct intra-arterial diastolic blood pressure (BP) measurements, indirect cuff mercury sphygmomanometer measurements, and automatic infrasonic recorder (IR) measurements. We used a receiver operating characteristic curve to determine whether a difference between the cuff and IR diastolic BP could identify patients likely to have pseudohypertension (cuff—intra-arterial diastolic BP difference of 10 mm Hg or greater). We found that a cuff-IR difference of 4 mm Hg could identify the majority of patients with pseudohypertension (sensitivity, 93%; specificity, 64%; positive predictive value, 62%; negative predictive value, 93%). We concluded that the IR is an accurate, quantitative, noninvasive substitute for intra-arterial measurements and may be the preferred technique for screening and monitoring of blood pressure in elderly hypertensive patients. (Arch Intern Med 1988;148:673-676)

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