In conditions of compromised peripheral circulation, the measurement of noninvasive continuous finger blood pressure with the Finapres device may show reduced accuracy. We therefore compared Finapres blood pressure (FINAP) with intrabrachial blood pressure (IAP) responses to the Valsalva maneuver and arising in 12 patients in whom the peripheral circulation was expected to be compromised due to the combination of therapy-resistant hypertension and vascular disease. During a 30 sec control period the FINAP--IAP differences were -15.7 +/- 18.8 mm Hg (mean +/- SD) for systolic, -20.1 +/- 15.7 mm Hg for mean, and -13.5 +/- 15.7 mm Hg for diastolic pressure. During the Valsalva maneuver and prolonged standing Finapres reproduced the essential characteristics of the changes in IAP in all patients. However, in individual patients, the magnitude of the intraarterial blood pressure response was sometimes over- or underestimated by Finapres. Nevertheless, the group averaged blood pressure, in particular mean and diastolic pressure, response to cardiovascular stimuli, was well reproduced by Finapres. In conclusion, as expected physiologically, individual Finapres measurements in patients with vascular disease do not always equal the intrabrachial pressure and should thus be evaluated with care. However, the Finapres device can be used with sufficient confidence to study the group averaged responses to cardiovascular stimuli in these patients.