ARTERIAL CLOSING PRESSURE CORRELATES WITH DIASTOLIC PSEUDOHYPERTENSION IN THE ELDERLY

Background. Pseudohypertension has frequently been reported in the eld erly population, with the diastolic measurement being the most frequen t source of error. There is no satisfactory noninvasive method of calc ulating the error in the blood pressure reading. We investigated the r ole of arterial closing pressure in the diagnosis of diastolic pseudoh ypertension. Methods. Indirect and direct blood pressure were measured in 24 elderly patients. Brachial artery closure was visualized by ult rasound in all subjects. Arterial closing pressure (ACP) was recorded as zero if the vessel was seen to close spontaneously when it was isol ated from central arterial pressure. If the vessel did not close spont aneously, a water cuff was applied externally over the artery and the additional pressure required to close it was recorded. Results. Diasto lic 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 ps eudohypertension. ACP correlated with the extent of diastolic pseudohy pertension (range: 5-17 mm Hg); r = .85, p < .001). Conclusion. We pro pose that ACP may be used to diagnose the presence and extent of pseud ohypertension.