Screening for pseudohypertension. A quantitative, noninvasive approach.

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 pseudo-hypertension (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 pseudo-hypertension (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.