A patient with sclerosis of the brachial artery may appear to be hypertensive if the blood pressure is measured using a sphygmomanometer.


Risk factor for sclerosis of the brachial artery:

(1) elderly patient

(2) diabetic with renal disease

(3) scleroderma


Clinical features:

(1) hypertensive blood pressure readings over the upper arm

(2) failure of blood pressure to respond to aggressive antihypertensive therapy

(3) evidence of arterial sclerosis

(4) normal intra-arterial blood pressure


Variable findings:

(1) positive Osler maneuver (determined by palpation of the radial or brachial arterial pulse)

(2) increased difference in blood pressure between the two arms


A patient with pseudohypertension may receive unnecessary antihypertensive therapy which can result in complications such as falls from orthostatic hypotension.


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