Abstract
Pulse Arrival Time (PAT) derived from Electrocardiogram (ECG) and Photoplethysmogram (PPG) for cuff-less Blood Pressure (BP) measurement has been a contemporary and widely accepted technique. However, the features extracted for it are conventionally from an isolated pulse of ECG and PPG signals. As a result, the estimated BP is intermittent. Objective: This paper presents feature extraction from each beat of ECG and PPG signals to make BP measurements uninterrupted. These features are extracted by employing Haar transformation to adaptively attenuate measurement noise and improve the fiducial point detection precision. Method: the use of only PAT feature as an independent variable leads to an inaccurate estimation of either Systolic Blood Pressure (SBP) or Diastolic Blood Pressure (DBP) or both. We propose the extraction of supplementary features that are highly correlated to physiological parameters. Concurrent data was collected as per the Association for the Advancement of Medical Instrumentation (AAMI) guidelines from 171 human subjects belonging to diverse age groups. An Adaptive Window Wavelet Transformation (AWWT) technique based on Haar wavelet transformation has been introduced to segregate pulses. Further, an algorithm based on log-linear regression analysis is developed to process extracted features from each beat to calculate BP. Results: The mean error of 0.43 and 0.20 mmHg, mean absolute error of 4.6 and 2.3 mmHg, and Standard deviation of 6.13 and 3.06 mmHg is achieved for SBP and DBP respectively. Conclusions: The features extracted are highly precise and evaluated BP values are as per the AAMI standards. Clinical Impact: This continuous real-time BP monitoring technique can be useful in the treatment of hypertensive and potential-hypertensive subjects.
Highlights
Hypertension has been termed as a silent killer because it adversely affects the body organs such as the brain and kidney, mostly without showing symptoms
As per the Global Health Observatory (GHO) data provided by the World Health Organization (WHO), raised blood pressure (BP), which is defined as 140 mmHg or higher for systolic blood pressure (SBP) and/or 90 mmHg or higher for diastolic blood pressure (DBP), affects 1.13 billion people worldwide [2], which is nearly grown twice since 1975 [3]
The error calculated by the comparison of estimated BP to the reference BP is used for statistical analysis performed using designated functions in MATLAB
Summary
Hypertension has been termed as a silent killer because it adversely affects the body organs such as the brain and kidney, mostly without showing symptoms. As per the Global Health Observatory (GHO) data provided by the World Health Organization (WHO), raised blood pressure (BP), which is defined as 140 mmHg or higher for systolic blood pressure (SBP) and/or 90 mmHg or higher for diastolic blood pressure (DBP), affects 1.13 billion people worldwide [2], which is nearly grown twice since 1975 [3] It is a leading risk factor for cardiovascular diseases and chronic kidney diseases [4], which are treatable in prior stages by continuous monitoring, by controlling the BP using drugs or by switching to a healthier lifestyle. The respective advantages and disadvantages have been summarized in [5] Among these techniques, the auscultatory and oscillometric have been quite popular for ambulatory measurement, but they
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