Cuff-Less and Continuous Blood Pressure Monitoring: A Methodological Review

Manuja Sharma,Devon Griggs,Sandeep Krishnan,Tzung Hsiai,Hung Cao,Jung-Chih Chiao,Karinne Barbosa,Victor Ho,Tadesse Ghirmai

doi:10.3390/technologies5020021

Abstract

Blood pressure (BP) is one of the most important monitoring parameters in clinical medicine. For years, the cuff-based sphygmomanometer and the arterial invasive line have been the gold standards for care professionals to assess BP. During the past few decades, the wide spread of the oscillometry-based BP arm or wrist cuffs have made home-based BP assessment more convenient and accessible. However, the discontinuous nature, the inability to interface with mobile applications, the relative inaccuracy with movement, and the need for calibration have rendered those BP oscillometry devices inadequate for next-generation healthcare infrastructure where integration and continuous data acquisition and communication are required. Recently, the indirect approach to obtain BP values has been intensively investigated, where BP is mathematically derived through the “Time Delay” in propagation of pressure waves in the vascular system. This holds promise for the realization of cuffless and continuous BP monitoring systems, for both patients and healthy populations in both inpatient and outpatient settings. This review highlights recent efforts in developing these next-generation blood pressure monitoring devices and compares various mathematical models. The unmet challenges and further developments that are crucial to develop “Time Delay”-based BP devices are also discussed.

Highlights

Cardiovascular disease (CVD) plagues our aging society as the leading cause of morbidity and mortality in developed countries [1,2]
It is possible to implement a pulse transit time (PTT)/Pulse arrival time (PAT)-based system that accurately predicts the trends of blood pressure (BP) instead of measuring BP itself
Considerable fluctuations in this trend can be used as a warning signal for users to monitor their BP and continuous monitoring of this variation can be helpful in clinical environments, as most vital parameters in operational theatres are measured continuously except for BP

Summary

Introduction

Cardiovascular disease (CVD) plagues our aging society as the leading cause of morbidity and mortality in developed countries [1,2]. High blood pressure (BP) or hypertension (HTN) is a common condition leading to CVD. HTN is determined by increased pressure in the arteries that can lead to stress on the heart, known as hypertensive heart disease. Are affected by HTN, while only 47% of patients maintain normal BP control [3]. HTN has been found associated with other health issues in various groups of populations, such as the elderly and pregnant women, to name a few [4,5].

Methods

Discussion

Conclusion