Comparison of Arm and Leg Blood-pressures in Aortic Insufficiency: An Appraisal of Hill's Sign

Abstract

Disproportionate femoral systolic hypertension in aortic insufficiency (Hill's sign) is based upon values obtained by indirect cuff determinations made in the arms and legs. Direct arterial punctures, using strain gauges and a multichannel recorder, in 20 persons with aortic insufficiency compared with 50 controls failed to reveal the presence of this sign. As in the normal supine controls, blood-pressures in the arms and legs in aortic insufficiency were found to be virtually the same. Various explanations for Hill's sign were discussed and found to be inadequate. It is suggested that until a better leg cuff is devised diagnostic problems should be resolved by intra-arterial punctures of the femoral arteries. © 1965, British Medical Journal Publishing Group. All rights reserved.