pseudohypertension

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{{for|other Osler's signs|Osler's sign (disambiguation)}}

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 calcification of blood vessels which cannot be compressed.{{cite web |url=http://www.merck.com/mkgr/mmg/sec11/ch85/ch85a.jsp |title=THE MERCK MANUAL OF GERIATRICS, Ch. 85, Hypertension |access-date=2008-12-20}} There is normal blood pressure when it is measured from within the artery.{{cite journal|last=Franklin|first=SS|author2=Wilkinson, IB |author3=McEniery, CM |title=Unusual hypertensive phenotypes: what is their significance?|journal=Hypertension|date=February 2012|volume=59|issue=2|pages=173–8|pmid=22184330|doi=10.1161/HYPERTENSIONAHA.111.182956|doi-access=free}} This condition however is associated with significant cardiovascular disease risk.

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.{{cn|date=October 2021}}

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".{{cn|date=October 2021}}

It occurs frequently in the elderly irrespective of them being hypertensive, and has moderate to modest intraobserver and interobserver agreement.Physical Diagnosis Secrets. Second Edition. Salvatore Mangione, MD It is also known as "Osler's maneuver".{{cite journal |author=Messerli FH |title=Osler's maneuver, pseudohypertension, and true hypertension in the elderly |journal=Am. J. Med. |volume=80 |issue=5 |pages=906–10 |date=May 1986 |pmid=2939716 |doi= 10.1016/0002-9343(86)90636-4}}{{cite journal |vauthors=Belmin J, Visintin JM, Salvatore R, Sebban C, Moulias R |title=Osler's maneuver: absence of usefulness for the detection of pseudohypertension in an elderly population |journal=Am. J. Med. |volume=98 |issue=1 |pages=42–9 |date=January 1995 |pmid=7825617 |doi=10.1016/S0002-9343(99)80079-5 }}

The sign is named for William Osler.

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. {{Cite journal |last1=Patil |first1=MilindM |last2=Kamalanathan |first2=Sadishkumar |last3=Sahoo |first3=JayaPrakash |last4=Vivekanandan |first4=Muthupillai |date=2016 |title=Pseudo hypertension: Clue from Osler sign |journal=Journal of Family Medicine and Primary Care |language=en |volume=5 |issue=3 |pages=743 |doi=10.4103/2249-4863.197277 |doi-access=free |issn=2249-4863 |pmc=5290806 |pmid=28217628}}