An Ambulatory Blood Pressure Monitor Mobile Health System for Early Warning for Stroke Risk: Longitudinal Observational Study (Preprint)

BACKGROUND Stroke, as a leading cause of death around the globe, has become a heavy burden on our society. Studies show that stroke can be predicted and prevented if a person’s blood pressure (BP) status is appropriately monitored via an ambulatory blood pressure monitor (ABPM) system. However, currently there exists no efficient and user-friendly ABPM system to provide early warning for stroke risk in real-time. Moreover, most existing ABPM devices measure BP during the deflation of the cuff, which fails to reflect blood pressure accurately. OBJECTIVE In this study, we sought to develop a new ABPM mobile health (mHealth) system that was capable of monitoring blood pressure during inflation and could detect early stroke-risk signals in real-time. METHODS We designed an ABPM mHealth system that is based on mobile network infrastructure and mobile apps. The proposed system contains two major parts: a new ABPM device in which an inflation-type BP measurement algorithm is embedded, and an abnormal blood pressure data analysis algorithm for stroke-risk prediction services at our health data service center. For evaluation, the ABPM device was first tested using simulated signals and compared with the gold standard of a mercury sphygmomanometer. Then, the performance of our proposed mHealth system was evaluated in an observational study. RESULTS The results are presented in two main parts: the device test and the longitudinal observational studies of the presented system. The average measurement error of the new ABPM device with the inflation-type algorithm was less than 0.55 mmHg compared to a reference device using simulated signals. Moreover, the results of correlation coefficients and agreement analyses show that there is a strong linear correlation between our device and the standard mercury sphygmomanometer. In the case of the system observational study, we collected a data set with 88 features, including real-time data, user information, and user records. Our abnormal blood pressure data analysis algorithm achieved the best performance, with an area under the curve of 0.904 for the low risk level, 0.756 for the caution risk level, and 0.912 for the high-risk level. Our system enables a patient to be aware of their risk in real-time, which improves medication adherence with risk self-management. CONCLUSIONS To our knowledge, this device is the first ABPM device that measures blood pressure during the inflation process and has obtained a government medical license. Device tests and longitudinal observational studies were conducted in Peking University hospitals, and they showed the device’s high accuracy for BP measurements, its efficiency in detecting early signs of stroke, and its efficiency at providing an early warning for stroke risk.

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An Ambulatory Blood Pressure Monitor Mobile Health System for Early Warning for Stroke Risk: Longitudinal Observational Study

JMIR mhealth and uhealth ◽

10.2196/14926 ◽

2019 ◽

Vol 7 (10) ◽

pp. e14926 ◽

Cited By ~ 1

Author(s):

Guangyu Wang ◽

Silu Zhou ◽

Shahbaz Rezaei ◽

Xin Liu ◽

Anpeng Huang

Keyword(s):

Blood Pressure ◽

Observational Study ◽

Real Time ◽

Early Warning ◽

Stroke Risk ◽

Risk Level ◽

Blood Pressure Monitor ◽

Pressure Monitor ◽

Blood Pressure Data ◽

Longitudinal Observational Studies

Background Stroke, as a leading cause of death around the globe, has become a heavy burden on our society. Studies show that stroke can be predicted and prevented if a person’s blood pressure (BP) status is appropriately monitored via an ambulatory blood pressure monitor (ABPM) system. However, currently there exists no efficient and user-friendly ABPM system to provide early warning for stroke risk in real-time. Moreover, most existing ABPM devices measure BP during the deflation of the cuff, which fails to reflect blood pressure accurately. Objective In this study, we sought to develop a new ABPM mobile health (mHealth) system that was capable of monitoring blood pressure during inflation and could detect early stroke-risk signals in real-time. Methods We designed an ABPM mHealth system that is based on mobile network infrastructure and mobile apps. The proposed system contains two major parts: a new ABPM device in which an inflation-type BP measurement algorithm is embedded, and an abnormal blood pressure data analysis algorithm for stroke-risk prediction services at our health data service center. For evaluation, the ABPM device was first tested using simulated signals and compared with the gold standard of a mercury sphygmomanometer. Then, the performance of our proposed mHealth system was evaluated in an observational study. Results The results are presented in two main parts: the device test and the longitudinal observational studies of the presented system. The average measurement error of the new ABPM device with the inflation-type algorithm was less than 0.55 mmHg compared to a reference device using simulated signals. Moreover, the results of correlation coefficients and agreement analyses show that there is a strong linear correlation between our device and the standard mercury sphygmomanometer. In the case of the system observational study, we collected a data set with 88 features, including real-time data, user information, and user records. Our abnormal blood pressure data analysis algorithm achieved the best performance, with an area under the curve of 0.904 for the low risk level, 0.756 for the caution risk level, and 0.912 for the high-risk level. Our system enables a patient to be aware of their risk in real-time, which improves medication adherence with risk self-management. Conclusions To our knowledge, this device is the first ABPM device that measures blood pressure during the inflation process and has obtained a government medical license. Device tests and longitudinal observational studies were conducted in Peking University hospitals, and they showed the device’s high accuracy for BP measurements, its efficiency in detecting early signs of stroke, and its efficiency at providing an early warning for stroke risk.

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Medical Device Integration with Electronic Health Records: A Case Study of University of Nairobi Health Services, Kenya

INTERNATIONAL JOURNAL OF COMPUTERS & TECHNOLOGY ◽

10.24297/ijct.v20i.8480 ◽

2020 ◽

Vol 20 ◽

pp. 14-21

Author(s):

David Muchangi Mugo ◽

Benard Mutisya Nzyoka Nzyoka ◽

Stephen Mburu Ng’ang’a

Keyword(s):

Blood Pressure ◽

Application Programming Interface ◽

Positive Outcome ◽

Blood Pressure Monitor ◽

Pressure Monitor ◽

Blood Pressure Data ◽

Application Programming ◽

Medical Records System ◽

The University ◽

Nursing Station

In this study, we describe a demonstration in which available electronic medical records system (EMR) was successfully integrated with a wireless blood pressure monitor (BPM). This was implemented by adopting the use of RESTful Application Programming Interface (API) technologies and commonly established standards designed for medical devices interoperability. Before deploying the prototype, we conducted pilot tests at the University of Nairobi, nursing station to get feedback on the time spent using the conventional blood pressure data capture methods and the newly integrated application. Clinical data from the device was exchanged adhering to the HL7/XML standard communication protocol. The findings indicate a positive outcome was availed on the time taken for the blood pressure readings, time spent by the patient at the nursing station, doctor’s time to search the patients’ blood pressure readings as well as the data accuracy fed in the EMR system.

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Fingertip Real-Time Blood Pressure Monitor Based on Phototransistor

Journal of Sensor Technology and Application ◽

10.12677/jsta.2019.73009 ◽

2019 ◽

Vol 07 (03) ◽

pp. 75-85

Author(s):

安怡袁

Keyword(s):

Blood Pressure ◽

Real Time ◽

Blood Pressure Monitor ◽

Pressure Monitor

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Study on Cuff-Less Blood Pressure Measurement Based on Electrocardiography and Photoplethysmography Signal

ICONIET PROCEEDING ◽

10.33555/iconiet.v2i3.34 ◽

2019 ◽

Vol 2 (3) ◽

pp. 206-214

Author(s):

Putri Indes Oktabriani ◽

Fuad Ughi ◽

Aulia Arif Iskandar

Keyword(s):

Blood Pressure ◽

Pressure Measurement ◽

Blood Pressure Monitoring ◽

Blood Pressure Measurement ◽

Ecg Signal ◽

Optimum Location ◽

Blood Pressure Monitor ◽

Pressure Monitor ◽

Left Hand ◽

Measure Blood Pressure

The continuous blood pressure measurement research is widely known for helpingthe development of ambulatory blood pressure monitoring where it measures blood pressureevery 15 to 30 minutes throughout the day. The cuff is a problem for the patient withAmbulatory Blood Pressure Monitor. It can make a person feel uncomfortable and must staystill when the cuff starts to inflate. It is limiting and disturbing their daily activity when thedevice is starting to measure the blood pressure. Blood pressure measurement without cuff isbeing proposed in this research, called cuff-less blood pressure measurement. It will be based onPhotoplethysmography (PPG) and Electrocardiography (ECG) signal analysis. ECG (Lead 1,Lead 2, and Lead 3) with PPG signal produced from index finger on the left hand are comparedand analyzed. Then the relation of PPG and ECG signal and the optimum location for daily usecan be obtained. The optimum location will be based on the electrode’s position that producedthe optimum ECG lead Signal to measure blood pressure. Based on the result, PPG and ECGsignal have a linear relation with Blood Pressure Measurement and Lead 1 is more stable inproducing the ECG signal. The equation from Lead 1 appeared as one of the optimum equationsfor measuring Systolic Blood Pressure (SBP) or Diastolic Blood Pressure (DBP).

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Effects of Neuroactive Amino Acids Derivatives on Cardiac and Cerebral Mitochondria and Endothelial functions in Animals Exposed to Stress

Journal of Clinical and Health Sciences ◽

10.24191/jchs.v2i2.5885 ◽

2017 ◽

Vol 2 (2) ◽

pp. 34

Author(s):

TA Popova ◽

II Prokofiev ◽

IS Mokrousov ◽

Valentina Perfilova ◽

AV Borisov ◽

...

Keyword(s):

Nitric Oxide ◽

Blood Pressure ◽

Platelet Aggregation ◽

Atp Synthesis ◽

Elevated Concentration ◽

Blood Pressure Monitor ◽

Pressure Monitor ◽

Griess Reagent ◽

Arterial Blood ◽

Endothelial Functions

Introduction: To study the effects of glufimet, a new derivative of glutamic acid, and phenibut, a derivative of γ-aminobutyric acid (GABA), on cardiac and cerebral mitochondria and endothelial functions in animals following exposure to stress and inducible nitric oxide synthase (iNOS) inhibition. Methods: Rats suspended by their dorsal cervical skin fold for 24 hours served as the immobilization and pain stress model. Arterial blood pressure was determined using a non-invasive blood pressure monitor. Mitochondrial fraction of heart and brain homogenates were isolated by differential centrifugation and analysed for mitochondrial respiration intensity, lipid peroxidation (LPO) and antioxidant enzyme activity using polarographic method. The concentrations of nitric oxide (NO) terminal metabolites were measured using Griess reagent. Hemostasis indices were evaluated. Platelet aggregation was estimated using modified version of the Born method described by Gabbasov et al., 1989. Results: The present study demonstrated that stress leads to an elevated concentration of NO terminal metabolites and LPO products, decreased activity of antioxidant enzymes, reduced mitochondrial respiratory function, and endothelial dysfunction. Inhibition of iNOS by aminoguanidine had a protective effect. Phenibut and glufimet inhibited a rise in stress-induced nitric oxide production. This resulted in enhanced coupling of substrate peroxidation and ATP synthesis. The reduced LPO processes caused by glufimet and phenibut normalized the endothelial function which was proved by the absence of average daily blood pressure (BP) elevation episodes and a significant increase in platelet aggregation level. Conclusion: Glufimet and phenibut restrict the harmful effects of stress on the heart and brain possibly by modulating iNOS activity.

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