Criteria for Diastolic Pressure: Revolution, Counterrevolution, and Now a Compromise

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Abstract
In 1967, an editorial entitled, "The Criterion for Diastolic Pressure: Revolution and Counterrevolution" appeared in a cardiology journal.1 The comments centered on deliberations of three committees appointed through the years by the American Heart Association. The charge of these committees was, among other things, to resolve the issue of whether the fourth phase of Korotkoff sounds (muffling) or the fifth phase (cessation) is the proper index of diastolic pressure. In 1939, the American Heart Association, together with the Cardiac Society of Great Britain and Ireland, recommended quite definitely that the fourth phase should be considered the index of diastolic pressure.2 REVOLUTION In 1951, a second committee of the American Heart Association reversed the recommendation of the 1939 International Committee and stated that the fifth phase was to be regarded as the more reliable index of diastolic pressure.3

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