Abstract
Continuous blood pressure (BP) monitoring in daily life is needed to enable early detection of hypertension and improve its control. Although pulse transit time (PTT)-based BP estimation represents a promising approach, it still lacks of performance in systolic blood pressure (SBP) estimation and its use in daily life is limited owing to the requirement of bulky systems for measurement of PTT. This study aims at developing a wearable system providing continuous PTT measurement and enhanced SBP estimation for continuous BP monitoring. A single chest-worn device was developed, which measures the photoplethysmogram and seismocardiogram simultaneously, and thereby obtains PTT by time difference between two signals. A multivariate model using the seismocardiogram amplitude (SA) in conjunction with PTT was proposed for SBP estimation, and validated against 30 healthy males (31.47 ± 7.23 years old). Performance of the proposed model was compared with that of conventional univariate models using PTT or pulse arrival time in two types of BP interventions, and for the verification of real use in daily life, performance assessment with calibration and BP monitoring in daily life were conducted. The results suggested that the proposed model (1) outperformed the conventional models, (2) showed potential to be generalized with just a simple calibration, and (3) demonstrated the potential of continuous BP monitoring in daily life. In conclusion, the presented system provides an improved performance of continuous BP monitoring by using a combination of PTT and SA with a convenient and compact single chest-worn device, and thus, it can contribute to mobile healthcare services.
Highlights
Hypertension is widespread in the US and is the major factor of cardiovascular disease, the leading cause of death in 2014 [1]–[4]
pulse pressure (PP) increased greatly compared to DBP (PP increased by 38.19±12.76% and DBP increased by 10.71±15.46%)
In the HDU protocol, systolic blood pressure (SBP) and DBP increased by 9.84±6.56% and 26.58±16.96%, respectively, whereas PP slightly decreased by −8.70±6.90%, which shows dominant changes in DBP compared to PP
Summary
Hypertension is widespread in the US and is the major factor of cardiovascular disease, the leading cause of death in 2014 [1]–[4]. To prevent such critical events, hypertension should be detected by checking one’s blood pressure (BP) status and properly managing it in its early stage. As one of the promising techniques to provide convenient measurement of BP, the pulse transit time (PTT)-based approach is receiving increasing attention. Numerous studies have attempted to employ the PTT–BP relationship for cuffless BP monitoring, most studies have used the pulse arrival time (PAT) instead, owing to its simplicity in measurement [5]–[10]. PAT is measured by employing the R-peak in an electrocardiogram (ECG) as proximal timing reference
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