Korotkoff Sounds - Systolic and Diastolic Blood Pressure

Systolic and Diastolic Blood Pressure

Traditionally, the systolic blood pressure is taken to be the pressure at which the first Korotkoff sound is first heard and the diastolic blood pressure is the pressure at which the fourth Korotkoff sound is just barely audible. However, there has recently been a move towards the use of the fifth Korotkoff sound (i.e. silence) as the diastolic blood pressure, as this has been felt to be more reproducible.

For pediatrics auscultation of the fifth Korotkoff sound is the guiding indicator of diastolic pressure.

The time average of the first Korotkoff sound represents a reliable pressure marker of systole of the heart. The time average of the fourth Korotkoff sound represents a reliable pressure marker of diastole of the heart.

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