Auscultatory Gap as a Marker of Risk

The auscultatory gap, a transient disappearance of Korotkoff sounds between systolic and diastolic pressures during blood pressure cuff deflation, is thought to cause underestimation of true systolic blood pressure; its prognostic and pathophysiologic correlates have not been well described.

These Cornell investigators studied 168 asymptomatic hypertensive patients using traditional auscultation techniques and a vibratory sensor. Left ventricular mass, geometric parameters, and cardiac output were measured on echo in all patients; atherosclerotic plaque and arterial wall stiffness were estimated through carotid untrasound. A classic auscultatory gap, which is independent of phasic respiratory changes, was noted in 21%; these patients were ol…