Response to Pseudohypertension

Abstract

Prof Spence1 has suggested that we have misconstrued his message with regard to pseudohypertension. Spence has long been interested in pseudohypertension in the elderly, as reflected in his list of personal publications on this topic. Indeed, he should be given credit for being the first to define this entity correctly as pseudodiastolic hypertension.2 However, as was the conventional wisdom in 1978 when he published his definitive study comparing intra-arterial with brachial cuff pressure,2 the treatment of hypertension in patients ≥65 years of age was controversial; all but very high levels of isolated systolic hypertension (ISH) values were ignored; and treating diastolic blood …