scholarly journals Improved agreement and diagnostic accuracy of a cuffless 24-h blood pressure measurement device in clinical practice

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Thenral Socrates ◽  
Philipp Krisai ◽  
Annina S. Vischer ◽  
Andrea Meienberg ◽  
Michael Mayr ◽  
...  

AbstractA cuffless blood pressure (BP) device (TestBP) using pulse transit time is in clinical use, but leads to higher BP values compared to a cuff-based 24 h-BP reference device (RefBP). We evaluated the impact of a recent software update on BP results and TestBP’s ability to differentiate between normo- and hypertension. 71 individuals had TestBP (Somnotouch-NIBP) and RefBP measurements simultaneously performed on either arm. TestBP results with software version V1.5 were compared to V1.4 and RefBP. Mean 24 h (± SD) BP for the RefBP, TestBP-V1.4 and TestBP-V1.5 were systolic 134.0 (± 17.3), 140.8 (± 20) and 139.1 (± 20) mmHg, and diastolic 79.3 (± 11.7), 85.8 (± 14.1) and 83.5 (± 13.0) mmHg, respectively (p-values < 0.001). TestBP-V1.5 area under the curve (95% confidence interval) versus RefBP for hypertension detection was 0.92 (0.86; 0.99), 0.94 (0.88; 0.99) and 0.77 (0.66; 0.88) for systolic and 0.92 (0.86; 0.99), 0.92 (0.85; 0.99) and 0.84 (0.74; 0.94) for diastolic 24 h, awake and asleep BP respectively. TestBP-V1.5 detected elevated systolic/diastolic mean 24 h-BP with a 95%/90% sensitivity and 65%/70% specificity. Highest Youden’s Index was systolic 133 (sensitivity 95%/specificity 80%) and diastolic 87 mmHg (sensitivity 81%/specificity 98%). The update improved the agreement to RefBP. TestBP was excellent for detecting 24 h and awake hypertensive BP values but not for asleep BP values.

2019 ◽  
Vol 9 (14) ◽  
pp. 2922 ◽  
Author(s):  
Shing-Hong Liu ◽  
Li-Jen Liu ◽  
Kuo-Li Pan ◽  
Wenxi Chen ◽  
Tan-Hsu Tan

With the advancement of wearable technology, many physiological monitoring instruments are gradually being converted into wearable devices. However, as a consumer product, the blood pressure monitor is still a cuff-type device, which does perform a beat-by-beat continuous blood pressure measurement. Consequently, the cuffless blood pressure measurement device was developed and it is based on the pulse transit time (PTT), although its accuracy remains inadequate. According to the cardiac hemodynamic theorem, blood pressure relates to the arterial characteristics and the contours of the pulse wave include some characteristics of the artery. Therefore, the purpose of this study was to use the contour characteristics of the pulses measured by photoplethysmography (PPG) to estimate the blood pressure using a linear multi-dimension regression model. Ten subjects participated in the experiment, and the blood pressure levels of the subjects were elevated by exercise. The results showed that the mean and standard deviation (mean ± SD) of the root mean square error of the estimated systolic and diastolic pressures within the best five parameters were 6.9 ± 2.81 mmHg and 4.0 ± 0.65 mmHg, respectively. Compared to the results that used one parameter, the PTT, for estimating the systolic and diastolic pressures, 8.2 ± 2.1 mmHg and 4.5 ± 0.79 mmHg, respectively, our results were better.


2021 ◽  
Vol 20 (4) ◽  
Author(s):  
Diana Carolina Martínez-Reyes

The main objective of this research is based on finding out some assertive and robust Photoplethysmogram’s PPG & Electrocardiogram’s ECG blood pressure-related parameters by the implementation of a novel method with innovations in signal processing and analysis. The biomedical ECG and PPG signals are recorded using a mobile monitor CardioQVark. To increase the cuffless blood pressure measurement accuracy, a technique that involves not only the ECG and PPG joint parameters extraction but also some individual PPG’s morphology features, is proposed in this work. Firstly, the biomedical ECG and PPG signals are time–frequency filtered. Secondly, some novel parameters from the morphology of photoplethysmogram signal, which may be correlated with blood pressure, are considered in addition to the pulse transit time. Additionally, a neural network is built to determine the relationship between the estimated and reference blood pressure. Finally, the correlation coefficient and regression line are obtained to evaluate the feasibility.


Sensors ◽  
2019 ◽  
Vol 19 (3) ◽  
pp. 595 ◽  
Author(s):  
Kwang Lee ◽  
Jongryun Roh ◽  
Dongrae Cho ◽  
Joonho Hyeong ◽  
Sayup Kim

Hypertension is a well-known chronic disease that causes complications such as cardiovascular diseases or stroke, and thus needs to be continuously managed by using a simple system for measuring blood pressure. The existing method for measuring blood pressure uses a wrapping cuff, which makes measuring difficult for patients. To address this problem, cuffless blood pressure measurement methods that detect the peak pressure via signals measured using photoplethysmogram (PPG) and electrocardiogram (ECG) sensors and use it to calculate the pulse transit time (PTT) or pulse wave velocity (PWV) have been studied. However, a drawback of these methods is that a user must be able to recognize and establish contact with the sensor. Furthermore, the peak of the PPG or ECG cannot be detected if the signal quality drops, leading to a decrease in accuracy. In this study, a chair-type system that can monitor blood pressure using polyvinylidene fluoride (PVDF) films in a nonintrusive manner to users was developed. The proposed method also uses instantaneous phase difference (IPD) instead of PTT as the feature value for estimating blood pressure. Experiments were conducted using a blood pressure estimation model created via an artificial neural network (ANN), which showed that IPD could estimate more accurate readings of blood pressure compared to PTT, thus demonstrating the possibility of a nonintrusive blood pressure monitoring system.


2021 ◽  
Vol 2071 (1) ◽  
pp. 012030
Author(s):  
M S Norsuriati ◽  
M S Norehan Mohd Sobri ◽  
H Zaidatul Hafiszah ◽  
A Mohamad Nazib ◽  
W Z Wan Suhaimizan ◽  
...  

Abstract Hypertension, commonly known as high blood pressure, is a major concern for people globally and in Malaysia. The hypertensive patient must commute to the hospital visiting their physician regularly for blood pressure (BP) monitoring using a cuff-based device. The patient may feel uncomfortable and pain when the device inflates the cuff and tightens around the arm for a BP measurement. Hence, to overcome this problem, this paper proposed a cuffless BP measurement using pulse transit time (PTT). In this method, a delay time between the peak of Photoplethysmogram (PPG) signals at the fingertip and the earlobe were correlated with BP. These signals were transferred to a computer via Arduino uno microcontroller and analyzed by the MATLAB R2019a software. A preliminary result shows that the developed system is able to record PTT and display the estimated BP value on the ThingSpeak webpage and ThingView apps. With the IoT platform, the cuffless BP can be monitor remotely, and the results can be store on the cloud healthcare system for hypertensive management.


2011 ◽  
Vol 27 (6) ◽  
pp. 266-268 ◽  
Author(s):  
Tony Joseph Eid ◽  
Amanda A Morris ◽  
Sachin A Shah

Objective: To report a case of hypertension secondary to ingestion of licorice root tea. Case Summary: A 46-year-old African American female with newly diagnosed stage 1 hypertension presented with a blood pressure measurement of 144/81 mm Hg and a reduced plasma potassium level of 3.2 mEq/L. The patient attempted lifestyle modifications prior to initiating an antihypertensive agent, but at a follow-up appointment, her blood pressure remained elevated. A current laboratory panel revealed a depressed morning plasma aldosterone concentration (PAC) of 5 ng/dL and low morning plasma renin activity (PRA) of 0.13 ng/mL/h. Later it was revealed that the patient regularly (1–2 cups/day) consumed “Yogi Calming” tea, a blend of herbs, including licorice root. The patient was advised to discontinue consumption of the herbal tea, and at a subsequent appointment, her blood pressure was 128/73 mm Hg and her laboratory panel had improved, including serum potassium concentration of 4.1 mEq/L, PAC of 6 ng/dL, and PRA of 0.19 ng/mL/h. Discussion: Excessive consumption of licorice has been well documented to cause pseudohyperaldosteronism, characterized by hypertension, hypokalemia, and suppressed plasma renin and aldosterone levels. Glycyrrhizin, the active ingredient in licorice, inhibits 11β-hydroxysteroid dehydrogenase type 2, an oxidase responsible for the conversion and inactivation of cortisol to cortisone. Chronic ingestion of licorice-containing foods has been demonstrated to cause pseudohyperaldosteronism. These include soft candies, lozenges, and dietary supplements, but licorice-containing teas have been infrequently described. Based on the Naranjo probability score, our patient's hypertension appears to have been a probable licorice-induced reaction secondary to a licorice-containing tea. Conclusions: Herbal and dietary supplements are frequently consumed by patients without full knowledge of the contents of the products or the impact on their health. In clinical practice, when hypertension is accompanied by hypokalemia and reduced PRA and PAC, licorice consumption should be investigated and causal hypertension ruled out.


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