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Osler's Maneuver in an Outpatient Clinic Setting

Nicholas P. Tsapatsaris, MD; Guy T. Napolitana, MD; Joseph Rothchild, MD
Arch Intern Med. 1991;151(11):2209-2211. doi:10.1001/archinte.1991.00400110067013.
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Osler's maneuver was performed on 912 consecutive outpatients aged 60 years or older in a 2-month period by 12 physicians. The incidence of an Osler-positive finding was 7.1% (65/912). The number of positive findings increased with age, ranging from 3.4% in the 60- to 70-year age group to 43.8% in the 86- to 90-year age group. A history of hypertension was present in 58.4% of patients with Osler-positive findings and in 59.6% of patients with Osler-negative findings. In a group of 48 previously screened patients who were independently examined, concordance was poor when the k test of reliability was used. Positive Osier findings were common in patients older than 70 years, in patients who smoked, and in patients with a high systolic blood pressure. These correlations may be related to a decrease in blood vessel compressibility, which may cause pseudohypertension. However, the findings on Osler's maneuver, are poorly reproducible, making the procedure an inadequate test.

(Arch Intern Med. 1991;151:2209-2211)


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