One of the most important indicators of human he alth is blood pressure. Timely detection of low or high indicators allows you to take all necessary measures to prevent the progression of the pathological process. Currently, blood pressure can be measured in the following ways: palpation, oscillometric and auscultatory. The latter is used by doctors. Another name for it is the Korotkov method. It allows you to identify and fix sound phenomena associated with the functioning of certain internal organs.
Korotkov method: concept
This method of measuring blood pressure is considered by doctors to be the most accurate and informative. The Korotkov auscultatory method has been recommended to doctors by the World He alth Organization since 1962.
The essence of the method is to assess the sound of the artery under a certain impact on it. Surgeon Korotkov N. S. in the course of research revealed that under pressure of variousforces 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 bend, fixing those moments during which noises appear and disappear. The Korotkov method involves the use of a manual tonometer equipped with a pear. The latter is designed for air injection. In addition, the measurement is not complete without a phonendoscope.
Physical basis of the Korotkov method
This method is non-invasive. In medicine, there is such a thing as "Korotkov's tones." These are specific sounds that can be heard with a stethoscope placed on the radial artery, both during inflation and at the time of its release.
During the measurement by the Korotkoff method, the following indicators are recorded:
- Systolic pressure. It is also called the top. It shows the pressure of fluid connective tissue during maximum contraction of the heart muscle.
- Diastolic pressure. It is called the bottom. It shows the blood pressure that occurs when the heart muscle relaxes to the maximum.
Thus, the Korotkov method involves first completely clamping the blood vessel with a cuff, and then releasing air from it. At each of these stages, the doctor listens to emerging tones.
The cuff is made of elastic fabric. The pressure in it is approximately equal to that which is characteristic of the skin and muscles in a relaxedcondition. As air enters the cuff, it begins to squeeze the arm and, accordingly, the artery. The natural consequence is the cessation of blood flow.
When the doctor begins to release air, the pressure decreases both in the cuff and in the soft tissues. When the indicator becomes equal to the systolic value, the blood will be able to break through the squeezed vessel. At this stage, it is customary to talk about the emergence of 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.
Advantages of the method
Measurement of pressure by the Korotkoff method is the most accurate and informative. This method is known all over the world and has been used in practice by doctors for many years.
Other benefits of the method:
- Simplicity and lightness. This method is very convenient, and therefore it can be used at home and other comfortable conditions.
- The final result is not at all affected by such a factor as a heart rhythm failure.
- No precise fixation of the limb is required. The test results are accurate even if the patient's hand is shaking with excitement.
Thus, the measurement of pressure by the Korotkoff method is a method that can be used by doctors of any speci alty. It allows you to accurately assess the patient's he alth status.
Flaws
Like any other method, this methodhas a number of disadvantages. His flaws:
- To do research well, certain skills are required. Very often, inexperienced people fail to find a pulsating blood vessel.
- Difficulties with measurement often occur in persons suffering from hearing and/or visual impairments.
- If the cuff moved during the examination, the procedure must be repeated. This is due to the fact that in the first case the results will be unreliable.
- The device needs to be calibrated every six months.
- Addiction to silence. There must be no sound in the room where the test is being carried out, otherwise the results will be inaccurate.
Despite the impressive list of shortcomings, the method is considered the most informative. In addition, at present, automatic devices are being sold on the medical equipment market that can be used at home even by those who are not fluent in the method.
Preparing for the study
Blood pressure is a variable value. It fluctuates throughout the day, and a large number of factors can affect this process. Normal daily fluctuations do not exceed 15 mmHg
It is recommended to measure blood pressure using the Korotkoff method several times a day:
- In a state of complete rest.
- During sports or during a period of psycho-emotional stress.
- In between daily activities.
For research to beas accurate as possible, you need 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 stop eating, smoking. In addition, hypothermia must 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 the chair.
- In the prone position, the limb must be placed along the body. The arm can also be slightly bent at the elbow, and the palm placed on the surface of the thigh.
- Move and talk during the examination is unacceptable.
- If it is necessary to measure the pressure several times in one session, in each case the position of the body must be changed. In addition, it is necessary to maintain an interval of 1 minute.
- It happens that the difference between the results on both hands is significant. In this case, measurements should be taken on the limb where the blood pressure is higher.
When interpreting the results, it must be taken into account that patients often have a “white coat effect”. In other words, when people see doctors, their blood pressure rises sharply. As a rule, when measured at home, it is lower by 30-40 mmHg
Research algorithm
After preparation, you can proceed directly to the measurements. Determination of blood pressure by the Korotkoff method:
- The patient takes the necessaryposition. 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 upper arm so that it is at the same level with 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 find a pulsating artery. Then he puts the phonendoscope on the blood vessel.
- The specialist begins to inflate the cuff with a pear. He does this until the movement of blood through the vessel stops.
- The doctor turns the valve, so that the air from the cuff begins to escape. The value at the appearance of the first tone is systolic pressure. The moment when all sounds disappear also needs to be fixed. This is the diastolic pressure.
It is important to remember all indicators as they are, that is, do not round them. It is recommended to measure the pressure 2 times in a row with an interval of 1 minute. Proper diagnostics allows you to timely identify pathologies that have a negative impact on the functioning of the heart muscle.
Measuring 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 the systolic index. At this time, specific noises appear.
- The second phase is characterized by the appearance of sounds associated with a lightrustling.
- The intensity of tones increases. The artery fills with blood, the vascular walls begin to oscillate.
- In the fourth phase, the tones reach their maximum volume and then gradually subside.
- Complete disappearance of all sounds. At this stage, the doctor records diastolic indicators.
Some factors (weight, age, gender, psycho-emotional state, etc.) only affect systolic values.
Equipment
To carry out diagnostics, it is enough to purchase a tonometer. Doctors usually work according to the Korotkov method, but even persons without medical education are able to take measurements. You just need to adapt and strictly follow the algorithm.
Tonometer can be purchased at pharmacies or stores specializing in the sale of medical equipment. The average cost of the device is 1500 rubles.
Causes of high blood pressure
120/80 is considered normal. If the indicators deviate upwards by 10% or more, it is customary to talk about an increase in blood pressure.
Main causes of this condition:
- Genetic predisposition.
- A lifestyle that does not imply physical activity.
- Unbalanced diet.
- Tobacco smoking.
- Frequent consumption of alcoholic beverages.
- Pathologies of the kidneys.
- Violation of the functioning of the nervous system.
- Atherosclerosis.
- Overwork.
- Long exposure to stress.
- Frequent consumption of high-s alt foods.
- Taking certain medications, such as Aspirin and Ibuprofen.
It is important to understand that high blood pressure negatively affects the functioning of the whole organism. In this regard, if you experience alarming symptoms, you should consult a doctor.
Causes of low blood pressure
It is customary to talk about hypotension at rates of 100/60 mm Hg. and below.
Main causes of the pathological condition:
- Heart failure.
- Bradycardia.
- Hypothyroidism.
- Adrenal insufficiency.
- Hypoglycemia.
- Dehydration.
- Hemorrhages.
- Anaphylactic reaction.
- Fasting.
Low blood pressure is also a he alth hazard. If you feel worse, you should contact a cardiologist.
In closing
The blood pressure indicator 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 Korotkoff method. Its essence is to listen to certain sounds that appear when the artery is squeezed and then restore its patency.
