Method specificity of the auscultatory estimates of the inodilatory reduction of diastolic blood pressure based on Korotkoff IV and V criteria.

Abstract

1. Non‐invasive measurements of blood pressure (BP) are method‐specific estimates of actual blood pressure. The agreement of the auscultatory Korokoff V ('disappearance' of sound, kv) and Korokoff IV ('sound muffling' kiv) cut‐off points in measuring diastolic blood pressure (DBP) was evaluated in healthy subjects in the presence of various controlled inodilatory interventions. 2. Eating (n = 8), 10 min i.v. infusion of 1 microgram min‐1 isoprenaline and adrenaline (n = 12), p.o. administration of 40 mg of the PDE‐III inhibitors isomazole and meribendan (n = 18) and p.o. administration of 1200 mg celiprolol (n = 15) caused evident chrono‐inodilatory responses: average HR increases of 7, 19, 10, 17, 17 and 8 beats min‐1, estimated CO increases of 1.6, 4.5, 2.3, 1.9, 2.6 and 1.8 1 min‐1 and average shortening of QS2c of 18, 41, 8, 37, 42 and 9 ms for food, isoprenaline, adrenaline, isomazole, meribendan and celiprolol, respectively. 3. In general, there was good agreement between DBPkV and DBPkIV measurements before the administration of the inodilatory treatments (bias DBPkV‐DBPkIV: 1‐ 2 mm Hg) but the extent of inodilatory DBP reduction (‐8, ‐6, ‐10, ‐2, ‐ 7 and ‐8 mm Hg according to DBPkIV for food, isoprenaline, adrenaline, isomazole, meribendan and celiprolol, respectively) was substantially overestimated when based on Korotkoff‐V rather than ‐IV (bias DBPkV‐ DBPkIV in estimating the inodilatory effect on DBP: ‐8, ‐12, 1, ‐13, ‐ 12 and ‐7 mm Hg for food, isoprenaline, adrenaline, isomazole, meribendan and celiprolol, respectively).(ABSTRACT TRUNCATED AT 250 WORDS) 1995 The British Pharmacological Society