False positive diagnosis of arterial hypertension: the diagnostic errors and their avoidance

Arterial hypertension is a risk factor both for morbidity and mortality. The diagnosis usually depends on the auscultation method using the cuff and the mercury manometer, which remains the international reference method. However, this indirect method is the source of numerous errors, sometimes important, which are related variously to the equipment used, the observer, the conditions under which the measurement is taken and sometimes to the patient. Such errors can in turn lead to therapeutic overdosage and to unnecessary treatment, which may be dangerous. “Pseudohypertension” is a typical example of the problems. Various means have been proposed to improve the reliability of measurements, above all the physician must adhere strictly to the correct routine. The use of self-registering equipment, provided it is scientifically assayed, can be considered for incidental measurements or for ambulant use. The ambulant measurement of arterial pressure promises to be of diagnostic, therapeutic and prognostic value, but further experience is required to confirm these impressions.