Heart Health High Blood Pressure Diagnosis How Is Pseudohypertension Diagnosed? Print By Craig Weber, MD | Medically reviewed by Richard N. Fogoros, MD Updated October 13, 2018 Rafe Swan/Cultura/Getty Images More in High Blood Pressure Diagnosis Causes & Risk Factors Treatment Living With Prevention Low Blood Pressure 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. Diagnosis of Pseudohypertension 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. Edited by Richard N. Fogoros, MD 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. Email Address Sign Up There was an error. Please try again. Thank you, , for signing up. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Zweifler, AJ, Shahab, ST. Pseudohypertension: A New Assessment. Journal of Hypertension, 11(1).Tsapatsaris, NP, et al. Osler's Maneuver in an Outpatient Clinic Setting. Archives of Internal Medicine, 151(11): 2209-11. Continue Reading