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 (P50 mm Hg (84.8%) and isolated systolic hypertension (27.3%). Mean systolic bias was 10.2 mm Hg with 95% limits of agreement of -13.1 and 33.6 mm Hg, mean diastolic bias was 4.8 mm Hg with limits of agreement of -11.0 and 20.7 mm Hg. The impact of body mass index, age, systolic blood pressure and pulse pressure on the absolute value of blood pressure bias was tested by stepwise multiple regression analysis. The systo!
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发表于 2013-10-17 20:38:58
