Abstract
Elevated blood pressure (BP) is a major cause of death, yet hypertension commonly goes undetected. Owing to its nature, it is typically asymptomatic until later in its progression when the vessel or organ structure has already been compromised. Therefore, noninvasive and continuous BP measurement methods are needed to ensure appropriate diagnosis and early management before hypertension leads to irreversible complications. Photoplethysmography (PPG) is a noninvasive technology with waveform morphologies similar to that of arterial BP waveforms, therefore attracting interest regarding its usability in BP estimation. In recent years, wearable devices incorporating PPG sensors have been proposed to improve the early diagnosis and management of hypertension. Additionally, the need for improved accuracy and convenience has led to the development of devices that incorporate multiple different biosignals with PPG. Through the addition of modalities such as an electrocardiogram, a final measure of the pulse wave velocity is derived, which has been proved to be inversely correlated to BP and to yield accurate estimations. This paper reviews and summarizes recent studies within the period 2010–2019 that combined PPG with other biosignals and offers perspectives on the strengths and weaknesses of current developments to guide future advancements in BP measurement. Our literature review reveals promising measurement accuracies and we comment on the effective combinations of modalities and success of this technology.
Highlights
Hypertension, or high blood pressure (BP), is a dangerous cardiac condition that accelerates end organ damage if not properly managed [1]
The impedance cardiography (ICG)-PPG modality produced correlation coefficients of 0.84 [19] and 0.88 [20] for SBP estimation, very small sample sizes of n = 3 [19] and n = 15 [20] indicates the need for further validation. These results suggest that incorporating ICG into PTT based BP estimation techniques holds potential for yielding accurate results with a wearable and user-friendly device
Papers were included in our review if they could be accessed in English and used PPG signals with simultaneously recorded but different biosignals to obtain BP estimations
Summary
Hypertension, or high blood pressure (BP), is a dangerous cardiac condition that accelerates end organ damage if not properly managed [1]. As this condition does not present noticeable symptoms early in its course, it is often not revealed unless regular BP monitoring is performed by health professionals or through self-management. PAT and PTT measurements both require the accurate detection of pulse at the distal artery This has most commonly been measured using PPG as it has the ability to detect changes in blood pulsation through monitoring the variation in light absorption from a photodetector placed near a light-emitting diode [7]. This review focuses on evaluating various PPG-based multimodal biosignal systems that have been investigated by researchers in an attempt to estimate BP and assess hypertension
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