Index of Indirect Estimation of Diastolic Blood Pressure

The best method for estimation of diastolic blood pressure by auscultation remains an unsettled issue. Korotkoff1originally recommended that complete cessation of vascular sounds be considered as the index of intra-arterial diastolic pressure. However, in 1939, joint committee of the American Heart Association and the Cardiac Society of Great Britain recommended that diastolic pressure be read at the level of muffling; but if sounds persist to lower level, then this also should be recorded. In 1951, committee functioning under the auspices of the American Heart Association2,3concluded that the disappearance of sounds is the better index of diastolic pressure and the level of muffling should be accepted only in those cases where vascular sounds persist to zero. In subsequent review, Burton4declared that the latter recommendation represents a major setback to medical science and stated that muffling of the induced arterial sounds is