Osler's Maneuver in outpatient veterans

A recently described procedure, Osler's Maneuver (OM), identifies patients with pseudohypertension. We examined the prevalence of OM positivity in consecutive outpatients at a Veterans Administration Medical Center. A total of 582 patients, median age of 61 years, were studied. OM was definitely positive in 3.4% (20/582). Age strongly related to OM (p less than 0.001). No patients under 50 were positive, while 15.6% (29/186) of those age 65 or older had a possible or definite OM. OM positive patients had higher systolic pressures than did OM negative patients (p less than 0.001). There was no significant relation between OM and diastolic pressure. In a regression analysis, definite or possible OM was associated with higher systolic pressure (p = .001). A moderate degree of observer variation in detection of OM was present (kappa = .675). OM positivity is common among the elderly, and so, pseudohypertension may occur more frequently than has been previously recognized.