Accuracy Of Systolic Blood Pressure Research Articles

Blood pressure to height ratio for screening hypertension among Indonesian adolescents

Background Pediatric hypertension is an emerging health issue due to its increasing prevalence. Age-, gender-, and height-specific blood pressure percentiles have been widely used as a primary tool for detection of hypertension in the pediatric population. However, this method is too complicated to be used in general pediatric practice. The blood pressure to height ratio has been proposed as a practical tool to detect hypertension in children.
 Objective To evaluate the accuracy of blood pressure to height ratio to be used as a tool for screening high blood pressure in Indonesian adolescents.
 Methods This diagnostic test study using data from the 2013 Indonesia Basic Health Research (Riset Kesehatan Dasar/RISKESDAS) report included 39,057 adolescents aged 15-18 years with complete data on age, gender, weight, height, and blood pressure. Blood pressure values were classified using the 2017 American Academy of Pediatrics (AAP) hypertension clinical guidelines. Blood pressure to height ratio was calculated as mmHg/cm body height. A receiver-operator characteristics (ROC) curve analysis was performed to assess the accuracy of systolic blood pressure to height ratio (SBPHR) and diastolic blood pressure to height ratio (DBPHR) for screening high blood pressure in adolescents. The optimal cut-off points, sensitivity, and specificity of SBPHR and DBPHR were calculated.
 Results The optimal cut-off points for defining elevated blood pressure in male adolescents aged 13-18 years were SBPHR 0.69 for male adolescents (sensitivity 96%, specificity 80%) and DBPHR 0.46 (sensitivity 97%, specificity 84%). In female adolescents, the optimal cut-offs were SBPHR 0.72 (sensitivity 97%, specificity 82%) and DBPHR 0.48 (sensitivity 98% and specificity 79%).
 Conclusion Blood pressure to height ratio is a practical method with high sensitivity and specificity for detecting elevated blood pressure in Indonesian adolescents aged 15 to 18 years.

A Wearable and Flexible Photoplethysmogram Sensor Patch for Cuffless Blood Pressure Estimation With High Accuracy

Hypertension is a very significant public health problem and has become a potential risk for cardiovascular and renal diseases. Blood pressure (BP) including systolic BP (SBP) and diastolic BP (DBP) is a vital parameter that should be monitored regularly for the early detection and prevention of chronic diseases. The traditional cuff-based BP monitors can cause discomfort to the users due to inflation and deflation. Here, a wearable and flexible photoplethysmography (PPG) patch sensor based on the polydimethylsiloxane (PDMS) substrate and double-layer serpentine structure with a closed loop that can omit the transfer printing process is proposed for cuffless BP estimation. Three models are adopted to estimate the BP. The accuracy of SBP and DBP obtained are 3.68 ± 2.37 and 4.9 ± 3.78 mmHg for the first model and 3.61 ± 2.62 and 4.72 ± 3.46 mmHg for the second model, respectively. The third model introduces the Kalman filtering to optimize the solution of the coefficients of the second model to forecast BP. As a result, the accuracy of SBP and DBP as high as 2.94 ± 2.35 and 3.41 ± 2.94 mmHg, respectively, is realized. The results show that the introduction of the Kalman filter algorithm to forecast BP can not only reduce the number of calibrations, but also improve the accuracy of BP estimation.

Wearable Piezoelectric-Based System for Continuous Beat-to-Beat Blood Pressure Measurement.

Non-invasive continuous blood pressure measurement is an emerging issue that potentially can be applied to cardiovascular disease monitoring and prediction. Recently, many groups have proposed the pulse transition time (PTT) method to estimate blood pressure for long-term monitoring. However, the PTT-based methods for blood pressure estimation are limited by non-specific estimation models and require multiple calibrations. This study aims to develop a low-cost wearable piezoelectric-based system for continuous beat-to-beat blood pressure measurement. The pressure change in the radial artery was extracted by systolic and diastolic feature points in pressure pulse wave (PPW) and the pressure sensitivity of the sensor. The proposed system showed a reliable accuracy of systolic blood pressure (SBP) (mean absolute error (MAE) ± standard deviation (SD) 1.52 ± 0.30 mmHg) and diastolic blood pressure (DBP, MAE ± SD 1.83 ± 0.50), and its performance agreed with standard criteria of MAE within 5 mmHg and SD within ±8 mmHg. In conclusion, this study successfully developed a low-cost, high-accuracy piezoelectric-based system for continuous beat-to-beat SBP and DBP measurement without multiple calibrations and complex regression analysis. The system is potentially suitable for continuous, long-term blood pressure-monitoring applications.

Oscillometric blood pressure estimation by combining nonparametric bootstrap with Gaussian mixture model

Background: Blood pressure (BP) is one of the most important vital indicators and plays a key role in determining the cardiovascular activity of patients.Methods: This paper proposes a hybrid approach consisting of nonparametric bootstrap (NPB) and machine learning techniques to obtain the characteristic ratios (CR) used in the blood pressure estimation algorithm to improve the accuracy of systolic blood pressure (SBP) and diastolic blood pressure (DBP) estimates and obtain confidence intervals (CI). The NPB technique is used to circumvent the requirement for large sample set for obtaining the CI. A mixture of Gaussian densities is assumed for the CRs and Gaussian mixture model (GMM) is chosen to estimate the SBP and DBP ratios. The K-means clustering technique is used to obtain the mixture order of the Gaussian densities.Results: The proposed approach achieves grade “A” under British Society of Hypertension testing protocol and is superior to the conventional approach based on maximum amplitude algorithm (MAA) that uses fixed CR ratios. The proposed approach also yields a lower mean error (ME) and the standard deviation of the error (SDE) in the estimates when compared to the conventional MAA method. In addition, CIs obtained through the proposed hybrid approach are also narrower with a lower SDE.Conclusions: The proposed approach combining the NPB technique with the GMM provides a methodology to derive individualized characteristic ratio. The results exhibit that the proposed approach enhances the accuracy of SBP and DBP estimation and provides narrower confidence intervals for the estimates.

The effect of cuff width on systolic blood pressure measurements in neonates

The width of the blood pressure cuff was found to have an effect on the accuracy of systolic blood pressure measured in the arm and thigh in neonates. Data were collected in 26 infants of a variety of birth weights and gestational ages. They show that the effect of cuff size can be minimized by selecting a cuff width equal to approximately 50% of the extremity circumference.