Pseudohypertension secondary to a noncompressible brachial artery

The interesting problem is considered of a comatose alcoholic diabetic with an extremely high systolic blood pressure, as determined by the usual means, who was subsequently found to have severe medial calcinosis and normal intraarterial blood pressure. The syndrome of the noncompressible brachial artery surely accounts for this patient's falsely elevated blood pressure reading. Though infrequently reported, this condition can be one cause of "difficult to control" hypertension in the elderly and in the diabetic patient.