A Centenary of Auscultatory Blood Pressure Measurement: A Tribute to Nikolai Korotkoff

Abstract

In 1905, Dr. Nikolai Korotkoff (1874–1920), a Russian surgeon, discovered a simple and precise technique to measure arterial pressure. He was born on 26th February 1874 in the central Russian city of Kursk. Korotkoff graduated from the Medical Faculty of Moscow University in 1898, but he worked later in the Surgical Clinic at the Imperial Military Medical Academy in St. Petersburg (Russia). Korotkoff served as a military surgeon during the Russo-Japanese War (1904–1905) and his major efforts were to find reliable clinical signs that could predict whether limb flow would be viable after vascular surgery of traumatic aneurysm. He found that after complete compression, the aneurysm of the arm (i.e. distal pulse on a. brachialis) disappeared with Riva-Rocci cuff and then gradually decreasing the pressure, a series of sounds could be heard by stethoscope under the artery distal to the compression. Korotkoff described four distinct phases of sounds: first sound, then compression murmurs, second tone, and disappearance of sounds. Korotkoff was also able to demonstrate the same auscultatory finding in healthy persons. He failed to notice only the muffled second sound, which was demonstrated a little later. These classical observations are now well known as the five different phases of Korotkoff sounds. In November 1905, during a conference of the Imperial Military Medical Academy, he reported his discovery in a short presentation entitled ‘On the issue of the methods for measuring blood pressure’. In 1939, the Joint Committee of the American Heart Association and the Cardiac Society of Great Britain and Ireland recognized officially and accepted worldwide Korotkoff’s method for blood pressure determining.

Acute effects of supramaximal exercise on carotid artery compliance and pulse pressure in young men and women

“…Systole and diastole were determined based on Kortokoff sounds (Paskalev et al 2005). Brachial BP was taken in duplicate and the average of the two values was recorded and used for subsequent analysis.…”

Reliability of palpation of the radial artery compared with auscultation of the brachial artery in measuring SBP

“…Although Korotkoff already observed that with his auscultatory technique SBP was approximately 10-12 mmHg higher compared with palpatory SBP measurements [4,5], a formal comparison on the difference between auscultatory and palpatory SBP was never reported. A previous Riva-Rocci revisited van der Hoeven et al 53 The upper row shows the percentage all readings (n ¼ 320) of which the difference between the pSBP and the aSBP is 5 mmHg, 10 mmHg, 15 mmHg, or >15 mmHg, respectively.…”

“…Contrary to blood pressure (BP) devices earlier used in the nineteenth century, his sphygmomanometer with inflatable cuff provided an easy way to perform sufficiently reliable, noninvasive, SBP measurements [1][2][3]. Nine years later, in 1905, the Russian surgeon Nikolai Korotkoff observed specific sounds when compressing arterial vessels, which eventually led to the auscultatory method for BP measurement [4,5]. Although auscultatory BP measurement is the present standard for clinical BP measurement, palpatory BP measurement is still embedded in current medical practice, as it is used to estimate the SBP level before commencing auscultatory BP measurement [6].…”

Karl Samuel Ritter Von Basch: the sphygmomanometer and the Empire

“…In 1828, Pouseiulle invented a device he called a 'hemodynamometer' that was able to measure blood pressure using a column of mercury. The hemodynamometer, however, required the insertion of a long U-shaped pipe inside an artery, and thus was deemed clinically inappropriate [7]. Carl Ludwig and Jules Herrison separately developed devices that were able to record blood pressure waves uninvasively.…”

“…He stated that the normal systolic blood pressure was between 135 and 165 mmHg, and observed that in individuals with Bright's disease (also known as glomerulonephritis) [2] it could be as high as 200 mmHg [7]. Von Basch identified a pathological entity characterized by elevated blood pressure he called 'latent atherosclerosis', and which probably represents today's essential hypertension [9].…”