Heart Health High Blood Pressure Diagnosis How Pseudohypertension Is Diagnosed By Craig O. Weber, MD Craig O. Weber, MD, is a board-certified occupational specialist who has practiced for over 36 years. Learn about our editorial process Craig O. Weber, MD Medically reviewed by Medically reviewed by Richard N. Fogoros, MD on November 18, 2019 facebook linkedin Richard N. Fogoros, MD, is a retired professor of medicine and board-certified internal medicine physician and cardiologist. Learn about our Medical Review Board Richard N. Fogoros, MD Updated on February 01, 2020 Print Pseudohypertension is an uncommon phenomenon, typically seen in elderly patients, in which the blood pressure measurement obtained with a sphygmomanometer (blood pressure cuff) is much higher than the actual blood pressure. Patients with pseudohypertension are mistakenly diagnosed as having hypertension when their blood pressure is actually normal. Rafe Swan / Cultura / Getty Images Diagnosis Pseudohypertension is caused by the thickening of the walls of the arteries that may occur with aging. This thickening makes the arteries very stiff and difficult to compress. Because measuring blood pressure depends on measuring how much force it takes to compress an artery, having thick, difficult-to-compress arteries falsely elevates the sphygmomanometer reading. Doctors usually suspect pseudohypertension in cases where: The blood pressure reading is very high over time, but the patient has no signs of organ damage or other complications. Attempting to treat the measured high blood pressure causes symptoms of low blood pressure (dizziness, confusion, decreased urine output). While a finger blood pressure meter or other similar devices may provide some useful data in cases of suspected pseudohypertension, the only way to confirm the diagnosis is by directly measuring the intraarterial blood pressure, that is, the pressure inside the blood vessel. This is done inserting a needle directly into a small artery. Previously, a noninvasive technique called Osler's maneuver was used instead of direct intraarterial measurement. However, data has shown that this technique produces poor results, and its use today is considered inappropriate. Was this page helpful? Thanks for your feedback! Looking to start a diet to better manage your high blood pressure? Our nutrition guide can help. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Tsapatsaris, NP, et al. Osler's Maneuver in an Outpatient Clinic Setting. Archives of Internal Medicine, 151(11): 2209-11. Zweifler, AJ, Shahab, ST. Pseudohypertension: A New Assessment. Journal of Hypertension, 11(1).