Blood pressure by Korotkoff's auscultatory method: end of an era or bright future?

In 1905 Nicolay Korotkoff described the auscultatory technique of blood pressure measurement, which developed into and still remains the standard in clinical medicine. This review article retraces in short the history of indirect blood pressure measurement and Korotkoff's biography. This historical perspective illustrates how progress in science is achieved by open-minded men, who take up the unfinished ideas of their predecessors and inspire their followers. Conventional sphygmomanometry is fraught with potential sources of error, which may arise in the subject, the observer, the sphygmomanometer or the overall application of the technique. Single auscultatory readings are not representative of the blood pressure during the whole day and may be biased by the white-coat phenomenon. These drawbacks have provoked the development of alternative approaches to blood pressure measurement, both auscultatory and oscillometric. Among them, ambulatory monitoring and to a lesser extent the self-measurement of blood pressure have elicited the greatest enthusiasm. However, these newer methods serve only as accessories to Korotkoff's auscultatory method, when the latter produces doubtful results. Thus, the new methods of blood pressure measurement need not herald the end of Korotkoff's old technique, but may rather stimulate its more deliberate and frequent use in the future.