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Arch Mal Coeur Vaiss. 1989 Jul;82(7):1007-11.

[Measurement of arterial pressure using 3 measurement methods in medial arterial calcification].

Archives des maladies du coeur et des vaisseaux

[Article in French]
F X Thierry, J M Dueymes, I Vernier, P Barbe, P Berg, P Dumazer, C Lumbroso, J J Conte

Affiliations

  1. Service de Néphrologie et d'hémodialyse, Toulouse.

PMID: 2510622

Abstract

Medial calcification of the arteries, because of non-distensibility of the blood vessel walls, may overestimate the real intra-arterial pressure when blood pressure (BP) is measured by indirect sphygmomanometry cuff. In order to assess the best method for measuring BP, we compared direct intra-arterial measurements with indirect cuff sphygmomanometry as well as automatic oscillometric measurements in 15 hypertensive patients. Mean age +/- standard deviation (SD) was 62 +/- 9 years; all patients had medial calcifications of forearm and/or brachial arteries, and Osler's maneuver was negative in all. Ten sets of direct and indirect BP measurements were obtained for each patient. Results are expressed as mean +/- SD: (table; see text) There was no significant difference between cuff pressure and systolic intra-arterial pressure. The automatic oscillometric method underestimated systolic intra-arterial BP. Great individual variability was observed and could not be predicted clinically. Indirect diastolic BP values were greater than intra-arterial BP in all patients with the sphygmomanometer cuff and in 10 patients with the oscillometric recorder. There existed a direct relation between intra-arterial BP and differences between indirect BP measurements and intra-arterial BP as follows: intra-arterial BP was overestimated by indirect methods for values under 150 mmHg, and underestimated above 150 mmHg. In conclusion, invasive intra-arterial BP measurement seem to be necessary to distinguish between hypertensive and pseudo-hypertensive patients, in case of radiologic evidence of arterial calcification.

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