Additional potential causes include diastolic runoff from chronic aortic regurgitation or AV fistula. Or there might be pseudohypertension, where the measured pressure is incorrect. There might be isolated systolic hypertension.
The most common is the summation of reflected pressures from increased vascular stiffness that comes with age. There are several reasons for widened pulse pressure in the elderly. This is not the setting in which to be alarmed. In medical training, it is imperative to be able to identify the "sick" patient, and this lady was apparently walking, talking, cheerful, and not under distress. My first response is that she appeared comfortable.
Now with that being said, let's talk about the "patient". Please don't be too offended at some incredulous off-color responses if your post is more fitting for a lay discussion. Second, you posted on a forum meant for physicians and residents. Additionally, most elderly people checking blood pressures at a pharmacy have had blood pressures taken before. Why scare an elderly lady with "you could have damage to your aorta", when honestly, you are speaking from a complete lack of experience? It appears that this lady took your advice in stride however, others may have become genuinely frightened. Although the comments thus far have been largely tongue-in-cheek, I am sorry to say that I agree with the overall sentiment that your comments were ill-advised.įirst, your advice was alarmist, and you are not a medical professional.
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