Lewis R R, Evans P J, McNabb W R, Padayachee T S
Department of Geriatric and General Medicine, Guys Hospital, London, UK.
J Hum Hypertens. 1994 Dec;8(12):879-85.
Indirect (cuff) and direct (intra-arterial) BPs were measured in 15 normotensive (mean age 79 years, range 72-88 years) and 21 hypertensive (mean age 76 years, range 65-89 years) elderly patients. Osler's test and arm arterial compliance, measured using Doppler-shifted ultrasound, were also assessed. In the normotensive, cuff systolic pressures were less than the direct by > 20 mmHg in 10 of the 15 (mean cuff systolic 139 +/- 13: direct 160 +/- 20 mmHg, P < 0.001); there was no statistical difference between the cuff and direct mean diastolic pressures (mean cuff diastolic 75 +/- 8; direct 70 +/- 10 mmHg). In the hypertensives, one had pseudohypertension (cuff systolic 186: direct 152 mmHg). However, cuff systolic pressures were less than the direct by > 20 mmHg in 11 (mean cuff systolic 205 +/- 26: direct 224 +/- 31 mmHg, P < 0.05); cuff diastolic pressures were greater than the direct by > 10 mmHg in 10 (mean cuff diastolic 102 +/- 14; direct 93 +/- 16 mmHg, P < 0.05). There was no significant difference between cuff and direct mean arterial pressures or the compliance in the normotensive and hypertensive groups. Osler's test was negative in the pseudohypertensive patient while in the four positive tests cuff systolic pressures were less than the direct measurements. In elderly patients there was no significant difference between the mean BP for cuff and direct measurements; systolic pseudohypotension and diastolic pseudohypertension are common and Osler's test is misleading.
对15名血压正常的老年患者（平均年龄79岁，范围72 - 88岁）和21名高血压老年患者（平均年龄76岁，范围65 - 89岁）测量了间接（袖带）和直接（动脉内）血压。还评估了使用多普勒频移超声测量的奥氏试验和臂动脉顺应性。在血压正常的患者中，15名中有10名袖带收缩压比直接测量值低>20 mmHg（平均袖带收缩压139±13：直接测量值160±20 mmHg，P<0.001）；袖带和直接测量的平均舒张压之间无统计学差异（平均袖带舒张压75±8；直接测量值70±10 mmHg）。在高血压患者中，1名患有假性高血压（袖带收缩压186：直接测量值152 mmHg）。然而，11名患者的袖带收缩压比直接测量值低>20 mmHg（平均袖带收缩压205±26：直接测量值224±31 mmHg，P<0.05）；10名患者的袖带舒张压比直接测量值高>10 mmHg（平均袖带舒张压102±14；直接测量值93±16 mmHg，P<0.05）。血压正常组和高血压组的袖带和直接平均动脉压或顺应性之间无显著差异。假性高血压患者的奥氏试验为阴性，而在4次阳性试验中，袖带收缩压低于直接测量值。在老年患者中，袖带和直接测量的平均血压之间无显著差异；收缩期假性低血压和舒张期假性高血压很常见，且奥氏试验具有误导性。
