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October 1963

Index of Indirect Estimation of Diastolic Blood Pressure: Muffling Versus Complete Cessation of Vascular Sounds

Author Affiliations

Arthur J. Moss, MD, Department of Pediatrics, School of Medicine, University of California Medical Center, Los Angeles 24, Calif.; From the Department of Pediatrics, School of Medicine, University of California at Los Angeles.

Am J Dis Child. 1963;106(4):364-367. doi:10.1001/archpedi.1963.02080050366004

The best method for estimation of diastolic blood pressure by auscultation remains an unsettled issue. Korotkoff1 originally recommended that complete cessation of vascular sounds be considered as the index of intra-arterial diastolic pressure. However, in 1939, a 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 a lower level, then this also should be recorded. In 1951, a committee functioning under the auspices of the American Heart Association2,3 concluded 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 a subsequent review, Burton4 declared that the latter recommendation represents "a major setback to medical science" and stated that muffling of the induced arterial sounds is

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