Pulse sounds and measurement of diastolic blood pressure in children

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Published on: April 29, 2013

M Uhari1, M Nuutinen, J Turtinen

  • 1Department of Paediatrics, University of Oulu, Finland.

Lancet (London, England)
|July 20, 1991
PubMed

Insights

Measuring diastolic blood pressure (BP) in children is debated, specifically using Korotkoff

Area of Science:

  • Pediatrics
  • Cardiovascular Health
  • Clinical Measurement

Background:

  • Diastolic blood pressure (BP) measurement in children lacks consensus regarding optimal auscultatory phase.
  • Korotkoff's fourth phase (K4) and fifth phase (K5) are debated indicators for diastolic BP in pediatric populations.

Purpose of the Study:

  • To evaluate the reliability and consistency of Korotkoff's fourth phase (K4) versus fifth phase (K5) for measuring diastolic blood pressure (BP) in children.
  • To determine the optimal auscultatory phase for accurate and repeatable diastolic BP measurements in pediatric age groups.

Main Methods:

  • Longitudinal study of 3012 Finnish children (aged 6-18 years) with repeated BP measurements in 1980, 1983, and 1986.
  • BP measured using mercury and random-zero sphygmomanometers, assessing the presence and difference between K4 and K5 diastolic BP.
  • Analysis of K4 and K5 absence rates and the correlation between the two phases across different age groups.

Main Results:

  • Korotkoff's fourth phase (K4) was consistently absent in 3.2% to 6.2% of children, while Korotkoff's fifth phase (K5) was absent in only 0.2% to 0.6%.
  • The difference between mean K4 and K5 diastolic BP ranged from 6.5 to 9.2 mm Hg, varying with age.
  • Both K4 and K5 diastolic BP measurements demonstrated good correlation across all pediatric age groups.

Conclusions:

  • Korotkoff's fifth phase (K5) is a more reliable and consistently obtainable indicator for diastolic blood pressure (BP) measurement in children.
  • Utilizing K5 for diastolic BP measurement ensures more reliable and repeatable assessments across all pediatric age groups, addressing measurement controversies.

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