PMID- 19881335
OWN - NLM
STAT- MEDLINE
DCOM- 20100120
LR  - 20091125
IS  - 1473-5725 (Electronic)
IS  - 1359-5237 (Linking)
VI  - 14
IP  - 6
DP  - 2009 Dec
TI  - Raising the arm before cuff inflation increases the loudness of Korotkoff sounds.
PG  - 268-73
LID - 10.1097/MBP.0b013e3283330a67 [doi]
AB  - INTRODUCTION: Recent guidelines suggest that Korotkoff sounds can be enhanced by 
      elevating the arm overhead for 30 s before inflating the cuff, and then bringing 
      the arm to the usual position to continue the blood pressure measurement. 
      MATERIALS AND METHODS: We evaluated the effect of this manoeuvre on the loudness 
      of the Korotkoff sound and on the accuracy of Riva-Rocci-Korotkoff (RRK) 
      measurements. Using an electronic stethoscope, we compared the amplitudes of 
      Korotkoff sounds between both arm positions. To determine the accuracy of blood 
      pressure measurements, which are performed after raising the arm first, we 
      validated this 'new method' of blood pressure measurement according to the 
      British Hypertension Society protocol. RESULTS: The amplitude of the first 
      Korotkoff sound with the arm elevated overhead for 30 s first, was 1.82+/-1.75 
      times greater (P<0.01) than the amplitude of the first Korotkoff sound with the 
      arm in the usual position. Second and third Korotkoff sounds were also louder. 
      RRK blood pressure measurements that were performed after raising the arm 
      overhead for 30 s did pass the validation procedure according to the British 
      Hypertension Society protocol. The nonsignificant difference (RRK after raising 
      the arm first-normal RRK measurements) was 0.33+/-2.85 mmHg for systolic and 
      -1.17+/-2.63 mmHg for diastolic measurements. CONCLUSION: Korotkoff sounds can be 
      enhanced by elevating the arm overhead for 30 s before inflating the cuff, and 
      then bringing the arm to the usual position to continue in the blood pressure 
      measurement. This manoeuvre leads to louder systolic Korotkoff sounds and does 
      not have an effect on measured blood pressure levels.
FAU - Verrij, Elisabeth Antoinette
AU  - Verrij EA
AD  - Department of Internal Medicine, Sint Antonius Hospital, Nieuwegein, The 
      Netherlands.
FAU - Nieuwenhuizen, Laurens
AU  - Nieuwenhuizen L
FAU - Bos, Willem Jan W
AU  - Bos WJ
LA  - eng
PT  - Journal Article
PL  - England
TA  - Blood Press Monit
JT  - Blood pressure monitoring
JID - 9606438
SB  - IM
MH  - Adult
MH  - Aged
MH  - Aged, 80 and over
MH  - Arm/physiopathology
MH  - Auscultation
MH  - Blood Pressure/physiology
MH  - Blood Pressure Determination/*methods
MH  - Female
MH  - Humans
MH  - Hypertension/physiopathology
MH  - Male
MH  - Middle Aged
EDAT- 2009/11/03 06:00
MHDA- 2010/01/21 06:00
CRDT- 2009/11/03 06:00
PHST- 2009/11/03 06:00 [entrez]
PHST- 2009/11/03 06:00 [pubmed]
PHST- 2010/01/21 06:00 [medline]
AID - 10.1097/MBP.0b013e3283330a67 [doi]
PST - ppublish
SO  - Blood Press Monit. 2009 Dec;14(6):268-73. doi: 10.1097/MBP.0b013e3283330a67.