INFLUENCE OF SEX, BODY MASS INDEX, AND SKIN COLOR ON THE ACCURACY OF NON-INVASIVE CUFFLESS PHOTOPLETHYSMOGRAPHY-BASED BLOOD PRESSURE MEASUREMENTS

Abstract

Objective: It is suggested that vital signs obtained by photoplethysmography-based devices might be influenced by subcutaneous fat and skin color. This study aimed to test the accuracy of blood pressure (BP) measurements taken using a photoplethysmography-based device by stratifying participants based on sex, body mass index (BMI), and skin color. Design and method: Ambulatory individuals coming for a routine BP checkup were recruited for an observational, comparative study. Systolic BP (SBP) and diastolic BP (DBP) measurements compared between the photoplethysmography-based and the cuff-based devices were stratified based on sex, BMI, and skin color (types 1–3 and 4–6 by the Fitzpatrick scale). Results: A total of 1548 measurements were nalysed. Correlations of SBP and DBP between the devices among males and females were between 0.914 to 0.987 (p < 0.001), Bland-Altman analysis of SBP and DBP showed a bias of less than 0.5 mmHg for both sexes. Correlations of SBP and DBP between the devices among BMI groups were between 0.931 to 0.991 (p < 0.001), Bland-Altman analysis of SBP and DBP showed a bias of less than 1 mmHg for all. Correlations of SBP and DBP between the devices among the skin color groups were between 0.936 to 0.983 (p < 0.001), Bland-Altman analysis of SBP and DBP showed a bias of less than 1 mmHg for all. Conclusions: This study shows similar and high agreement rates between BP measurements obtained using a PPG-based non-invasive cuffless BP device and a cuff-based BP device across sex, BMI groups, and skin color.