Page 62 - Clinical Pearls in Cardiology

50 Clinical Pearls in Cardiology

blood pressure is measured using a sphygmomanometer.
But the actual blood pressure is within normal limits
when direct intra-arterial recording of blood pressure
is done using a probe.
Pseudohypertension is seen in elderly people due
to arteriosclerosis which reduces the compressibility of
the brachial artery. Detecting pseudohypertension (by
demonstrating positive Osler’s sign) is important because
these patients (usually the elderly or the chronically-ill),
are prone to develop postural hypotension. The problem
of postural hypotension in these patients may be
aggravated by further increasing their antihypertensive
treatment on the basis of a false blood pressure reading
that is actually much higher than their real blood
pressure.
31. What is meant by white-coat hypertension?
White-coat hypertension is a condition in which a
normotensive subject becomes hypertensive during the
blood pressure measurement. But the blood pressure
settles down to normal level outside the medical
environment. It is best demonstrated by ambulatory
blood pressure measurement.
32. What is meant by ‘cuff hypertension’?
The Riva-Rocci cuff is an inelastic cloth that encircles the
arm and it encloses the inflatable rubber bladder. There is
unequivocal evidence that either too narrow or too short
a bladder (i.e. undercuffing) will cause overestimation
of blood pressure. This phenomenon is called as “cuff
hypertension”. Ideally the bladder inside the cuff should
encircle 80% of the arm (standard adult cuff size is
12 cm width × 26 cm length). It has to be remembered that
using the standard adult cuff to record blood pressure
in very obese people with large arm circumference can