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Old 07-01-2011
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Sphygmomanometer Hypertension: compliant on meds and BP 170/90

A 73-yr-old man with h/o hypertension presents for a BP check. He is compliant with medication. It was found to be 170/90. He does not smoke or drink alcohol. He walks several miles per day and take salt restricted diet. He is on 4 antihypertensive medications and brachial artery is palpable on raising the BP cuff pressure above systolic pressure.
What is the next step in management?

a. add 5th antihypertensive med
b. maximize the medication dose
c. measure intrarterial pressure directly.
d. no further management
e. stress the importance of compliance
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Old 07-04-2011
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Answer is C; measure the intraarterial pressure directly.
older patient have non-compressible vessel and falsely elevated pressure reading by syphgmomanometery. so its necessary to measure intraarterial pressure directly before adding or increasing dose.
palpable brachial or radial artery when cuff is raised above systolic pressure is known as Osler's sign (psudohypertension)

but how u measure intraarterial pressure directly...anyone plz?
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Old 07-04-2011
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Quote:
Originally Posted by confident View Post
but how u measure intraarterial pressure directly...anyone plz?
It is done by using a catheter into the artery.
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Old 07-04-2011
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Quote:
Originally Posted by Sadalssud View Post
It is done by using a catheter into the artery.
could u explain how catheter into artery... it need to get connected at other end with measuring apparatus??..i know it silly but jst out of curiosity....i never heard about it
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Quote:
Originally Posted by confident View Post
could u explain how catheter into artery... it need to get connected at other end with measuring apparatus??..i know it silly but jst out of curiosity....i never heard about it
Hi Confident, you may find this article helpful: http://www.frca.co.uk/Documents/137%...easurement.pdf
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