Osler's maneuver and pseudohypertension

The New England Journal of Medicine
F H MesserliC Amodeo

Abstract

We describe a simple bedside procedure (which we call "Osler's maneuver") that differentiates patients with true hypertension from those whose blood pressure is spuriously elevated because of excessive sclerosis of the large arteries ("pseudohypertension"). The maneuver is performed by assessing the palpability of the pulseless radial or brachial artery distal to a point of occlusion of the artery manually or by cuff pressure. We classified 24 elderly hypertensive patients as either Osler-positive (n = 13) or Osler-negative (n = 11), and measured their intraarterial pressure, arterial compliance, and systemic hemodynamics. Patients with pseudohypertension (Osler-positive) had falsely elevated blood-pressure readings, with a difference of 10 to 54 mm Hg between cuff and intraarterial pressure. Arterial compliance was lower in Osler-positive subjects and correlated with the difference between cuff and intraarterial pressures, indicating that the stiffer the artery, the more pronounced the degree of pseudohypertension. Pseudohypertension is common in the elderly and becomes more severe as arterial compliance decreases and sclerosis of large arteries progresses.

References

Dec 18, 1976·Lancet·G JacksonJ Condon
Jul 28, 1979·British Medical Journal
Aug 1, 1978·American Heart Journal·J V Jones, D I Graham
Nov 1, 1975·Anesthesiology·C T WallaceJ E Mahaffey
Mar 1, 1984·Archives of Internal Medicine·F H MesserliE D Frohlich
Jul 1, 1984·American Heart Journal·H VenturaE D Frohlich
Sep 1, 1984·Circulation·W B Kannel, T J Thom

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Citations

Dec 1, 1992·Cardiovascular Drugs and Therapy·L H Opie
Apr 1, 1995·Journal of General Internal Medicine·R H Baker, J Ende
May 17, 2001·Current Hypertension Reports·D C Felmeden, G Y Lip
May 11, 2002·Current Hypertension Reports·David A CalhounMari K Nishizaka
Sep 13, 2006·Current Hypertension Reports·C Venkata S Ram
Aug 13, 2011·Journal of Human Hypertension·J BlacherM E Safar
Mar 14, 2012·Nature Reviews. Cardiology·Eduardo Pimenta, Suzanne Oparil
Nov 14, 1985·The New England Journal of Medicine
Aug 20, 1992·The New England Journal of Medicine·J F Setaro, H R Black
Apr 13, 1995·The New England Journal of Medicine·F H Messerli
Jul 28, 2006·The New England Journal of Medicine·Marvin Moser, John F Setaro
Aug 22, 2000·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·F H LuC J Chang
May 20, 1998·The American Journal of the Medical Sciences·D RobertsonM J Lichtenstein
Apr 16, 2002·Home Healthcare Nurse·M Murphy
Mar 12, 2003·American Journal of Therapeutics·C Venkata S Ram
Jul 23, 2008·American Journal of Therapeutics·Peter Bolli
Dec 25, 2013·European Heart Journal·Stefano F RimoldiFranz H Messerli
Jan 1, 2008·Journal of the American Society of Hypertension : JASH·Michael F O'Rourke, Audrey Adji
Dec 23, 2016·Clinica Chimica Acta; International Journal of Clinical Chemistry·P M O'SheaM Fitzgibbon
Aug 8, 2006·Journal of Cardiovascular Pharmacology and Therapeutics·Dimitris P Papadopoulos, Vasilios Papademetriou
May 11, 2004·Physiological Measurement·Timothy G ForanJohn Feely
Oct 3, 2008·Journal of Human Hypertension·M E SafarJ Blacher
Sep 1, 1995·Hypertension·S G BlankT G Pickering
Mar 1, 1988·Hypertension·E D Frohlich
Jul 1, 1992·Hypertension·W J BosG A van Montfrans
Jun 15, 2016·Hypertension·Karsten HeusserJens Jordan
Dec 21, 2011·Hypertension·Stanley S FranklinCarmel M McEniery
Feb 8, 2019·Current Hypertension Reports·Scott J DankelJeremy P Loenneke
May 1, 2019·Current Neurology and Neuroscience Reports·Zachary BulwaJosé Biller
Jan 27, 2016·Wiener medizinische Wochenschrift·Peter Dovjak
Jan 28, 2020·Hypertension·Dean S PiconeUNKNOWN Invasive Blood Pressure Consortium
Mar 1, 1989·Postgraduate Medicine·M D Cressman, R W Gifford
Jul 1, 1988·Journal of the American Geriatrics Society·M L TuckJ E Morley
Oct 16, 2016·Current Hypertension Reports·Kevin T SchleichMichael E Ernst
Nov 8, 2018·Zeitschrift für Gerontologie und Geriatrie·Dhayana Dallmeier, Michael D Denkinger
May 10, 2020·High Blood Pressure & Cardiovascular Prevention : the Official Journal of the Italian Society of Hypertension·Valentina RovellaNicola Di Daniele
Jan 15, 1986·Hospital Practice·F H Messerli
Mar 17, 1999·Journal of the American Geriatrics Society·A AuseonL A Lipsitz

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