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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
Published on: April 23, 2021
Recognizing malingering hypertension in young adults.
Naomi Nussinovitch1, Edna Peleg, Moshe Nussinovitch
1Hypertension Unit, Department of Internal Medicine, Chaim Sheba Medical Center, Tel Hashomer, Israel. nussim@clalit.org.il
Blood Pressure Monitoring
|November 18, 2009
Summary
Malingering hypertension in young adults presents distinct ambulatory blood pressure patterns. Recognizing these differences can prevent unnecessary treatments for suspected hypertension.
Area of Science:
- Cardiology
- Clinical Medicine
- Hypertension Research
Background:
- Hypertension is uncommon in young adults, raising suspicion for malingering when cooperation is poor and treatment fails.
- Malingering hypertension involves external secondary gain and lack of patient cooperation during diagnosis.
Purpose of the Study:
- To investigate if abnormal ambulatory blood pressure patterns can indicate malingering hypertension.
- To differentiate malingering hypertension from essential hypertension in young adults.
Main Methods:
- Evaluated young adults (19-20 years) with high ambulatory blood pressure.
- Utilized clinical interviews, physical exams, and 24-hour ambulatory blood pressure monitoring.
- Compared blood pressure patterns in normotensive, essential hypertension, and suspected malingering hypertension groups (20 each).
Main Results:
- Both essential and suspected malingering hypertension groups showed elevated day/night blood pressure compared to normotensive individuals.
- Malingering hypertension group exhibited greater blood pressure fluctuations.
- Malingering hypertension group had lower percentages of time with abnormally high systolic blood pressure and higher maximum heart rates during day and night compared to essential hypertension.
Conclusions:
- Patients with malingering hypertension constitute a distinct clinical group.
- Clinical suspicion, proposed criteria, and unique blood pressure patterns aid diagnosis.
- Accurate identification of malingering hypertension can avert unnecessary medical and surgical interventions.
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