Pseudohypertension, also known as pseudohypertension in the elderly, noncompressibility artery syndrome, and Osler's sign (or Osler sign) of pseudohypertension is a falsely elevated blood pressure reading obtained through sphygmomanometry due to calcificationofblood vessels which cannot be compressed.[1] There is normal blood pressure when it is measured from within the artery.[2] This condition however is associated with significant cardiovascular disease risk.[2]
Because the stiffened arterial walls of arteriosclerosis do not compress with pressure normally, the blood pressure reading is theoretically higher than the true intra-arterial measurement.[citation needed]
To perform the test (also named Osler maneuver), one first inflates the blood pressure cuff above systolic pressure to obliterate the radial pulse. One then attempts to palpate the radial artery, a positive test is if it remains palpable as a firm "tube".[citation needed]
It occurs frequently in the elderly irrespective of them being hypertensive, and has moderate to modest intraobserver and interobserver agreement.[3] It is also known as "Osler's maneuver".[4][5]
Osler sign occurs due to Monckeberg's sclerosis of arteries. Unlike atherosclerotic change in the intimal layer of arterial lumen, It is the calcification in the media of small or mediate-size arteries within four limbs. Sometimes it also affects renal and coronary arteries. On X-ray, it shows "rail-tracking" appearance. Clinically, pseudohypertension should be considered once one develops dizziness without lowering blood pressure after he/she starts or escalates antihypertensive agents. [6]
^Physical Diagnosis Secrets. Second Edition. Salvatore Mangione, MD
^Messerli FH (May 1986). "Osler's maneuver, pseudohypertension, and true hypertension in the elderly". Am. J. Med. 80 (5): 906–10. doi:10.1016/0002-9343(86)90636-4. PMID2939716.
^Belmin J, Visintin JM, Salvatore R, Sebban C, Moulias R (January 1995). "Osler's maneuver: absence of usefulness for the detection of pseudohypertension in an elderly population". Am. J. Med. 98 (1): 42–9. doi:10.1016/S0002-9343(99)80079-5. PMID7825617.
