Osler's maneuver in an outpatient clinic setting

Osler's maneuver was performed on 912 consecutive outpatients aged 60 years of 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 kappa test of reliability was used. Positive Osler 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 pseudo-hypertension. However, the findings on Osler's maneuver, are poorly reproducible, making the procedure an inadequate test.