Abstract

Continuous blood pressure (BP) monitoring has a significant meaning for the prevention and early diagnosis of cardiovascular disease. However, under different calibration methods, it is difficult to determine which model is better for estimating BP. This study was firstly designed to reveal a better BP estimation model by evaluating and optimizing different BP models under a justified and uniform criterion, i.e., the advanced point-to-point pairing method (PTP). Here, the physical trial in this study caused the BP increase largely. In addition, the PPG and ECG signals were collected while the cuff bps were measured for each subject. The validation was conducted on four popular vascular elasticity (VE) models (MK-EE, L-MK, MK-BH, and dMK-BH) and one representative elastic tube (ET) model, i.e., M-M. The results revealed that the VE models except for L-MK outperformed the ET model. The linear L-MK as a VE model had the largest estimated error, and the nonlinear M-M model had a weaker correlation between the estimated BP and the cuff BP than MK-EE, MK-BH, and dMK-BH models. Further, in contrast to L-MK, the dMK-BH model had the strongest correlation and the smallest difference between the estimated BP and the cuff BP including systolic blood pressure (SBP) and diastolic blood pressure (DBP) than others. In this study, the simple MK-EE model showed the best similarity to the dMK-BH model. There were no significant changes between MK-EE and dMK-BH models. These findings indicated that the nonlinear MK-EE model with low estimated error and simple mathematical expression was a good choice for application in wearable sensor devices for cuff-less BP monitoring compared to others.

Highlights

  • Increased aortic stiffness in hypertensive individuals is a fundamental manifestation of longstanding hypertensionrelated damage that stiffens the large arteries [1]

  • Five most popular blood pressure (BP) estimation models were investigated and optimized based on Pulse arrival time (PAT) under the same advanced point pairing method (PTP) method for the first time. e investigation revealed that the MK-EE and dMK-BH, as two vascular elasticity (VE) models based on the Moens–Korteweg equation, were more efficient than the elastic tube (ET) model based on the conservation of mass and momentum equation

  • Considering that the change of human BP was affected by many physiological factors and manifests as a complex nonlinear system, the L-MK with the largest estimated BP error among VE models was not a good choice for ambulatory BP monitoring (ABPM)

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Summary

Introduction

Increased aortic stiffness in hypertensive individuals is a fundamental manifestation of longstanding hypertensionrelated damage that stiffens the large arteries [1]. Instantaneous information about BP status can be obtained from conventional standard cuff-based BP measurements, such as oscillometry [4] and auscultation. For cuff-based approaches, recurrent inflating and deflating of the cuff stress the patient, which causes periodic interruptions to blood flow, affecting the physiological state of the patient and disturbing the quality of sleep [7]. The cuff-less solution has a Journal of Healthcare Engineering promising application prospect for continuous noninvasive BP monitoring by virtue of overcoming disturbance issues existing in the traditional cuff-based method [8, 9]. PPG is a feasible technology for cuff-less continuous BP monitoring, especially in surgery, and can provide valuable information on physiological heart monitoring and cardiovascular system assessment of vascular parameters [10, 11]

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