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June 20, 1977

Management of Hypertension

JAMA. 1977;237(25):2720. doi:10.1001/jama.1977.03270520030011

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To the Editor.—  Dr Irving Page's article on the errors in management of hypertension (236:2621, 1976) is certainly appropriate. However, it omits a variety of pitfalls that may be encountered.Some patients have different blood pressure readings in both arms, eg, they have a normal pressure on one side and an elevated one on the other side. Persons with peripheral vascular disease may have low blood pressures in both arms and have elevated intraarterial pressure. Temporary blood pressure elevations occur with emotional stress, acute physical derangements, or after intake of certain drugs and beverages in normotensive persons. Patients with carotid artery obstructions may lose their elevated blood pressure after successful surgical repair without having true hypertension. Not all hypertensive persons can tolerate blood pressure reduction to normal values.