One of the most important indicators of human health is blood pressure. Timely detection of low or high indicators allows you to take all the necessary measures to prevent the progression of the pathological process. Currently, blood pressure measurement can be carried out in the following ways: by palpation, oscillometric and auscultatory. The latter is used by doctors. Its other name is the Korotkov method. It allows you to identify and record sound phenomena associated with the functioning of certain internal organs.
Korotkov method: concept
Doctors consider this method of measuring blood pressure the most accurate and informative. Korotkov's auscultatory method since 1962 has been recommended to doctors by the World Health Organization.
The essence of the method is to evaluate the sound of an artery with a certain effect on it. Surgeon Korotkov N.S. during the research revealed that under the pressure of various strengths in the blood vessel specific noises and tones arise. It was this discovery that formed the basis of the method.
During the study, doctors listen to the artery at the elbow, fixing those moments during which noises appear and disappear. Korotkov’s method involves the use of a hand tonometer equipped with a pear. The latter is designed to pump air. In addition, the measurement is not complete without a phonendoscope.
Physical foundations of the Korotkov method
This method is non-invasive. In medicine, there is such a thing as “Korotkov tones”. These are specific sounds that can be heard with the help of a phonendoscope placed on the radial artery, both during air injection and at the moments of its release.
In the process of measurement by the Korotkov method, the following indicators are recorded:
- Systolic pressure. It is also called the top. It shows the pressure of fluid connective tissue during the maximum contraction of the heart muscle.
- Diastolic pressure. It is called the bottom. It shows the blood pressure that occurs with maximum relaxation of the heart muscle.
Thus, the Korotkov method implies first the complete compression of the blood vessel by the cuff, and then the release of air from it. At each of these stages, the doctor listens to emerging tones.
The cuff is made of stretch fabric. The pressure in it is approximately equal to that which is characteristic of the skin and muscles in a relaxed state. As air enters the cuff, it begins to squeeze the arm and, accordingly, the artery. A natural consequence is the cessation of blood flow.
When the doctor begins to release air, the pressure decreases in the cuff and in the soft tissues. When the indicator becomes equal to the systolic value, blood can break through a squeezed vessel. At this stage, it is customary to talk about the occurrence of a turbulent flow. This process is accompanied by specific noises and tones. If you continue to reduce the pressure, you can restore the flow of fluid connective tissue. With a sharp weakening of tones, it is customary to talk about diastolic pressure.
The advantages of the method
Korotkov’s pressure measurement is the most accurate and informative. This method is known throughout the world and has been used in practice by doctors for many years.
Other advantages of the method:
- Simplicity and lightness. This method is very convenient, and therefore it can be used in home and other comfortable conditions.
- The final result is completely unaffected by such a factor as a malfunction of the heart rhythm.
- Clear limb fixation is not required. The results of the study are accurate even if the patient trembles with excitement.
Thus, pressure measurement by the Korotkov method is a method that can be used by doctors of any specialty. It allows you to accurately assess the health status of the patient.
disadvantages
Like any other method, this method has several disadvantages. Its disadvantages:
- In order to conduct a quality study, certain skills are required. Very often, inexperienced people cannot find a pulsating blood vessel.
- Difficulty in measuring often occurs in individuals suffering from hearing and / or visual impairment.
- If the cuff has moved during the study, the procedure must be repeated. This is due to the fact that in the first case, the results will be unreliable.
- The device needs calibration every six months.
- Addiction to silence. In the room where the study is conducted, there should be no sounds, otherwise the results will be inaccurate.
Despite the impressive list of shortcomings, the method is considered the most informative. In addition, at the present time, automatic devices are being sold on the medical equipment market that can be used at home even to those who are not fluent in the method.
Study preparation
Blood pressure is a variable value. It fluctuates throughout the day, and a large number of factors can affect this process. Normally, daily fluctuations do not exceed 15 mm Hg.
It is recommended to measure blood pressure by the Korotkov method several times a day:
- In a state of complete rest.
- During sports or during a period of psycho-emotional stress.
- In between the implementation of daily activities.
In order for the study to be as accurate as possible, it is necessary to properly prepare for it and take into account some of the nuances:
- Half an hour before determining the pressure by the Korotkov method, it is important to refuse food intake, smoking. In addition, hypothermia should be avoided.
- Immediately before the procedure, it is recommended to be in the position in which measurements are planned for several minutes.
- If a person is sitting, be sure to lean on the back of a chair.
- In the supine position, the limb must be positioned along the body. You can also bend your arm slightly at the elbow, and place your palm on the surface of the thigh.
- Moving and talking during the study is unacceptable.
- If in one session it is necessary to measure the pressure several times, in each case the position of the body must be changed. In addition, it is necessary to maintain an interval of 1 minute.
- It so happens that the difference between the results on both hands is significant. In this case, measurements should be carried out on that limb where the blood pressure indicator is greater.
During the interpretation of the results, it must be borne in mind that often the “white coat effect” is revealed in patients. In other words, in people seeing doctors, blood pressure rises sharply. As a rule, when measured at home, it is 30-40 mm Hg lower.
Research Algorithm
After preparation, you can proceed directly to the measurements. Determination of blood pressure by the Korotkov method:
- The patient is in the right position. It is important to ensure that the legs are parallel to each other, that is, they should not be crossed.
- The doctor puts the cuff on the shoulder so that it is on the same level as the heart. In this case, the product should capture most of the shoulder. After that, the specialist checks for a gap between the cuff and the limb (it should be).
- The doctor palpates to detect a pulsating artery. Then he puts a phonendoscope on a blood vessel.
- The specialist begins to blow air into the cuff with the help of a pear. He does this until the movement of blood through the vessel stops.
- The doctor turns the valve, so that air begins to escape from the cuff. The value when the first tone appears is systolic pressure. The moment when all the sounds disappear, you also need to fix. This is diastolic pressure.
It is important to remember all indicators as they are, that is, not to round them. It is recommended to measure pressure 2 times in a row with an interval of 1 minute. Correct diagnosis allows timely detection of pathologies, the course of which has a negative effect on the work of the heart muscle.
Measurement phases
Surgeon Korotkov identified 5 stages in the process of determining blood pressure:
- The appearance of the first sounds. At this stage, the specialist fixes a systolic indicator. Specific noises appear at this time.
- The second phase is characterized by the appearance of sounds associated with a slight rustling.
- The intensity of tones increases. The artery is filled with blood, the vascular walls begin to fluctuate.
- In the fourth phase, tones reach maximum volume and then gradually fade.
- The complete disappearance of all sounds. At this stage, the doctor fixes diastolic indicators.
Some factors (weight, age, gender, psycho-emotional state, etc.) affect only systolic values.
Equipment
For diagnostics, it is enough to purchase a tonometer. According to the Korotkov method, usually doctors work, but people without a medical education are able to take measurements. It’s enough to adapt and strictly follow the algorithm.
The tonometer can be purchased at pharmacies or stores specializing in the sale of medical equipment. The average cost of the device is 1,500 rubles.
Reasons for high blood pressure
Normal values are 120/80. If the indicators deviate upward by 10% or more, it is customary to talk about an increase in blood pressure.
The main causes of this condition:
- Genetic predisposition.
- A lifestyle that does not imply motor activity.
- Unbalanced diet.
- Smoking
- Frequent use of alcohol-containing drinks.
- Pathology of the kidneys.
- Impaired functioning of the nervous system.
- Atherosclerosis.
- Overwork.
- Staying long under stress.
- Frequent use of foods containing large amounts of salt.
- Taking certain medications, in particular, Aspirin and Ibuprofen.
It is important to understand that increased pressure negatively affects the functioning of the whole organism. In this regard, if alarming symptoms occur, consult a doctor.
Reasons for low blood pressure
It is customary to talk about hypotension at rates of 100/60 mm Hg. and below.
The main causes of the pathological condition:
- Heart failure.
- Bradycardia
- Hypothyroidism
- Adrenal insufficiency.
- Hypoglycemia.
- Dehydration.
- Hemorrhage.
- Anaphylactic reaction.
- Starvation.
Low blood pressure is also a health hazard. If you feel worse, you need to contact a cardiologist.
Finally
Blood pressure is clinically significant in the diagnosis of a large number of diseases. Currently, there are several ways to measure it. The most popular is the Korotkov method. Its essence lies in listening to certain sounds that appear when the artery is squeezed and then restores its patency.