Real-time Blood Pressure Research Articles

Real-time Blood Pressure Prediction on Wearable Devices using Edge Based Deep Neural Networks: A Hardware-software Co-design Approach

This paper presents the hardware realization of a real-time blood pressure (BP) prediction model for wearable devices, utilizing long short-term memory (LSTM) deep neural networks (DNNs). The proposed system uses both electrocardiogram (ECG) and photoplethysmogram (PPG) signal values for BP prediction. It aims to address the limitations of traditional BP measurement methods, providing a low error, minimal computational overhead, more accurate and convenient alternative system for individuals with hypertension or at risk for cardiovascular diseases. The utilization of split matrix approach leads to a reduction in hardware complexity across the entire system. This technique involves breaking down the larger weight matrices used in the computations of DNNs into smaller matrices. This fragmentation results in a decrease in the complexity of the hardware responsible for performing matrix vector multiplications (MVMs) within LSTMs. The resultant architecture of the predictive model gains several advantages, including a lowered level of complexity in terms of the space occupied by individual cells, decreased processing delay, and reduced power consumption. Furthermore, this approach enables the achievement of a notably improved minimum achievable clock period of 2.972 ns. This prediction model can operate locally on wearable devices, reducing the reliance on cloud computing and improving privacy and security. The performance evaluations are carried out using both analytical and implementation results. The results indicate that the proposed model can be practically applied to real-world problems and can potentially enhance the accuracy of various machine-learning tasks.

Using Behavioural Biometrics and Machine Learning in Smart Gadgets for Continuous User Authentication Purposes

In the ever-evolving realm of technology, the identification of human activities using intelligent devices such as smartwatches, fitness bands, and smartphones has emerged as a crucial area of study. These devices, equipped with inertial sensors, gather a wealth of data and provide insights into users' movements and behaviors. These data not only serve practical purposes, but also hold significant implications for domains such as healthcare and fitness tracking. Traditionally, these devices have been employed to monitor various health metrics such as step counts, calorie expenditure, and real-time blood pressure monitoring. However, recent research has shifted its focus to leveraging the data collected by these sensors for user authentication purposes. This innovative approach involves the utilization of Machine Learning (ML) models to analyze the routine data captured by sensors in smart devices employing ML algorithms, which can recognize and authenticate users based on their unique movement patterns and behaviors. This introduces a paradigm shift from traditional one-time authentication methods to continuous authentication, adding an extra layer of security to protect users against potential threats. Continuous authentication offers several advantages over its conventional counterparts. First, it enhances security by constantly verifying a user's identity through their interaction with the device, thereby mitigating the risk of unauthorized access. Second, it provides a seamless and nonintrusive user experience, eliminating the need for repetitive authentication prompts. Moreover, it offers robust protection against various threats such as identity theft, unauthorized access, and device tampering. The application of continuous authentication extends beyond individual devices and encompasses interconnected systems and networks. This holistic approach ensures a comprehensive security across digital platforms and services. The experiments demonstrate that the logistic regression model achieves an accuracy of 82.32% on the test dataset, highlighting its robustness for binary classification tasks. Additionally, the random forest model outperforms with a 92.18% accuracy, emphasizing its superior capability in handling complex feature interactions. In the study, the sequential neural network achieved an accuracy of 92% on the HAR dataset, outperforming traditional machine learning models by a significant margin. The model also demonstrated robust generalization capabilities with a minimal drop in performance across various cross-validation folds.

Revolutionizing Chronic Heart Disease Management: The Role of IoT-Based Ambulatory Blood Pressure Monitoring System.

Chronic heart disease (CHD) is a widespread and persistent health challenge that demands immediate attention. Early detection and accurate diagnosis are essential for effective treatment and management of this condition. To overcome this difficulty, we created a state-of-the-art IoT-Based Ambulatory Blood Pressure Monitoring System that provides real-time blood pressure readings, systolic, diastolic, and pulse rates at predefined intervals. This unique technology comes with a module that forecasts CHD's early warning score. Various machine learning algorithms employed comprise Naïve Bayes, K-Nearest Neighbors (K-NN), random forest, decision tree, and Support Vector Machine (SVM). Using Naïve Bayes, the proposed model has achieved an impressive 99.44% accuracy in predicting blood pressure, a vital aspect of real-time intensive care for CHD. This IoT-based ambulatory blood pressure monitoring (IABPM) system will provide some advancement in the field of healthcare. The system overcomes the limitations of earlier BP monitoring devices, significantly reduces healthcare costs, and efficiently detects irregularities in chronic heart diseases. By implementing this system, we can take a significant step forward in improving patient outcomes and reducing the global burden of CHD. The system's advanced features provide an accurate and reliable diagnosis that is essential for treating and managing CHD. Overall, this IoT-based ambulatory blood pressure monitoring system is an important tool for the early identification and treatment of CHD in the field of healthcare.

A comparative study of ProRithm and standard monitoring techniques for non-invasive blood pressure measurement using photoplethysmography and electrocardiography signals through artificial intelligence/machine learning methods

Background: Multi-parameter monitoring devices are essential for providing real-time patient data, which is crucial for effective healthcare interventions. This clinical trial evaluated the accuracy of the ProRithm beat-to-beat cuffless device for arterial blood pressure monitoring, comparing it with a standard sphygmomanometer. Methods: This observational study included 30 subjects aged 18 and above. Systolic and diastolic blood pressure measurements from both the ProRithm device and the Philips Monitor were compared using statistical analysis. Results: The analysis revealed no statistically significant differences between the ProRithm device and the manual method. In comparison with manual measurements using a sphygmomanometer, the mean systolic blood pressure was 131.2 mmHg with ProRithm it was 129.3 mmHg. Similarly, with the manual method, while the mean diastolic blood pressure was 76.2 mmHg and with ProRithm it was 75.9 mmHg. Conclusions: This study indicates that portable, small-sized devices like ProRithm, which facilitate remote monitoring, are effective for real-time blood pressure assessment in clinical settings.

A Continuous Non-Invasive Blood Pressure Prediction Method Based on Deep Sparse Residual U-Net Combined with Improved Squeeze and Excitation Skip Connections.

Arterial blood pressure (ABP) serves as a pivotal clinical metric in cardiovascular health assessments, with the precise forecasting of continuous blood pressure assuming a critical role in both preventing and treating cardiovascular diseases. This study proposes a novel continuous non-invasive blood pressure prediction model, DSRUnet, based on deep sparse residual U-net combined with improved SE skip connections, which aim to enhance the accuracy of using photoplethysmography (PPG) signals for continuous blood pressure prediction. The model first introduces a sparse residual connection approach for path contraction and expansion, facilitating richer information fusion and feature expansion to better capture subtle variations in the original PPG signals, thereby enhancing the network's representational capacity and predictive performance and mitigating potential degradation in the network performance. Furthermore, an enhanced SE-GRU module was embedded in the skip connections to model and weight global information using an attention mechanism, capturing the temporal features of the PPG pulse signals through GRU layers to improve the quality of the transferred feature information and reduce redundant feature learning. Finally, a deep supervision mechanism was incorporated into the decoder module to guide the lower-level network to learn effective feature representations, alleviating the problem of gradient vanishing and facilitating effective training of the network. The proposed DSRUnet model was trained and tested on the publicly available UCI-BP dataset, with the average absolute errors for predicting systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean blood pressure (MBP) being 3.36 ± 6.61 mmHg, 2.35 ± 4.54 mmHg, and 2.21 ± 4.36 mmHg, respectively, meeting the standards set by the Association for the Advancement of Medical Instrumentation (AAMI), and achieving Grade A according to the British Hypertension Society (BHS) Standard for SBP and DBP predictions. Through ablation experiments and comparisons with other state-of-the-art methods, the effectiveness of DSRUnet in blood pressure prediction tasks, particularly for SBP, which generally yields poor prediction results, was significantly higher. The experimental results demonstrate that the DSRUnet model can accurately utilize PPG signals for real-time continuous blood pressure prediction and obtain high-quality and high-precision blood pressure prediction waveforms. Due to its non-invasiveness, continuity, and clinical relevance, the model may have significant implications for clinical applications in hospitals and research on wearable devices in daily life.

A new method of continuous blood pressure monitoring using multichannel sensing signals on the wrist

Hypertension is a worldwide health problem and a primary risk factor for cardiovascular disease. Continuous monitoring of blood pressure has important clinical value for the early diagnosis and prevention of cardiovascular disease. However, existing technologies for wearable continuous blood pressure monitoring are usually inaccurate, rely on subject-specific calibration and have poor generalization across individuals, which limit their practical applications. Here, we report a new blood pressure measurement method and develop an associated wearable device to implement continuous blood pressure monitoring for new subjects. The wearable device detects cardiac output and pulse waveform features through dual photoplethysmography (PPG) sensors worn on the palmar and dorsal sides of the wrist, incorporating custom-made interface sensors to detect the wearing contact pressure and skin temperature. The detected multichannel signals are fused using a machine-learning algorithm to estimate continuous blood pressure in real time. This dual PPG sensing method effectively eliminates the personal differences in PPG signals caused by different people and different wearing conditions. The proposed wearable device enables continuous blood pressure monitoring with good generalizability across individuals and demonstrates promising potential in personal health care applications.

Non-invasive continuous blood pressure prediction based on ECG and PPG fusion map.

To achieve real-time blood pressure monitoring, a novel non-invasive method is proposed in this article. Electrocardiographic (ECG) and pulse wave signals (PPG) are fused from a multi-omics signal-level perspective. A physiological signal fusion matrix and fusion map, which can estimate the blood pressure of blood loss(BPBL), are constructed. The results demonstrate the efficacy of the fusion map model, with correlation values of 0.988 and 0.991 between the estimated BPBL and the true systolic blood pressure (SBP) and diastolic blood pressure (DBP), respectively. The root mean square errors for SBP and DBP were 3.21mmHg and 3.00mmHg, respectively. The model validation showed that the fusion map method is capable of simultaneous highlighting of the respective characteristics of ECG and PPG and their correlation, improving the utilization of the information and the accuracy of BPBL. This article validates that physiological signal fusion map can effectively improve the accuracy of BPBL estimation and provides a new perspective for the field of physiological information fusion.

Dynamic Modeling of Carbon Dioxide Transport through the Skin Using a Capnometry Wristband.

The development of a capnometry wristband is of great interest for monitoring patients at home. We consider a new architecture in which a non-dispersive infrared (NDIR) optical measurement is located close to the skin surface and is combined with an open chamber principle with a continuous circulation of air flow in the collection cell. We propose a model for the temporal dynamics of the carbon dioxide exchange between the blood and the gas channel inside the device. The transport of carbon dioxide is modeled by convection-diffusion equations. We consider four compartments: blood, skin, the measurement cell and the collection cell. We introduce the state-space equations and the associated transition matrix associated with a Markovian model. We define an augmented system by combining a first-order autoregressive model describing the supply of carbon dioxide concentration in the blood compartment and its inertial resistance to change. We propose to use a Kalman filter to estimate the carbon dioxide concentration in the blood vessels recursively over time and thus monitor arterial carbon dioxide blood pressure in real time. Four performance factors with respect to the dynamic quantification of the CO2 blood concentration are considered, and a simulation is carried out based on data from a previous clinical study. These demonstrate the feasibility of such a technological concept.

Survey and Evaluation of Hypertension Machine Learning Research.

Background Machine learning (ML) is pervasive in all fields of research, from automating tasks to complex decision-making. However, applications in different specialities are variable and generally limited. Like other conditions, the number of studies employing ML in hypertension research is growing rapidly. In this study, we aimed to survey hypertension research using ML, evaluate the reporting quality, and identify barriers to ML's potential to transform hypertension care. Methods and Results The Harmonious Understanding of Machine Learning Analytics Network survey questionnaire was applied to 63 hypertension-related ML research articles published between January 2019 and September 2021. The most common research topics were blood pressure prediction (38%), hypertension (22%), cardiovascular outcomes (6%), blood pressure variability (5%), treatment response (5%), and real-time blood pressure estimation (5%). The reporting quality of the articles was variable. Only 46% of articles described the study population or derivation cohort. Most articles (81%) reported at least 1 performance measure, but only 40% presented any measures of calibration. Compliance with ethics, patient privacy, and data security regulations were mentioned in 30 (48%) of the articles. Only 14% used geographically or temporally distinct validation data sets. Algorithmic bias was not addressed in any of the articles, with only 6 of them acknowledging risk of bias. Conclusions Recent ML research on hypertension is limited to exploratory research and has significant shortcomings in reporting quality, model validation, and algorithmic bias. Our analysis identifies areas for improvement that will help pave the way for the realization of the potential of ML in hypertension and facilitate its adoption.

Toward Real-Time Blood Pressure Monitoring via High-Fidelity Iontronic Tonometric Sensors with High Sensitivity and Large Dynamic Ranges.

Continuous, noninvasive blood pressure (CNIBP) monitoring provides valuable hemodynamic information that renders detection of the early onset of cardiovascular diseases. Wearable mechano-electric pressure sensors that mount on the skin are promising candidates for monitoring continuous blood pressure (BP) pulse waveforms due to their excellent conformability, simple sensing mechanisms, and convenient signal acquisition. However, it is challenging to acquire high-fidelity BP pulse waveforms since it requires highly sensitive sensors (sensitivity larger than 4 × 10-5 kPa-1 ) that respond linearly with pressure change over a large dynamic range, covering the typical BP range (5-25kPa). Herein, this work introduces a high-fidelity, iontronic-based tonometric sensor (ITS) with high sensitivity (4.82 kPa-1 ), good linearity (R2 > 0.995), and a large dynamic range (up to 180% output change) over a broad working range (0 to 38kPa). Additionally, the ITS demonstrates a low limit of detection at 40Pa, a fast load response time (35ms) and release time (35ms), as well as a stable response over 5000 load per release cycles, paving ways for potential applications in human-interface interaction, electronic skins, and robotic haptics. This work further explores the application of the ITS in monitoring real-time, beat-to-beat BP by measuring the brachial and radial pulse waveforms. This work provides a rational design of a wearable pressure sensor with high sensitivity, good linearity, and a large dynamic range for real-time CNIBP monitoring.

An Unobtrusive, Wireless and Wearable Single-Site Blood Pressure Monitor Based on an Armband Using Electrocardiography (ECG) and Reflectance Photoplethysmography (PPG) Signal Processing

Wearable medical devices (WMDs) for healthcare applications have become ubiquitous, allowing remote, at-home, and real-time chronic monitoring that have significantly decongested clinics. These WMDs permitted the monitoring of several physiological parameters, such as heart and respiration rates, SPO2, temperature, and energy expenditure during activities of daily living (ADLs) or fitness activities. While the measurement of these parameters has become common, full noninvasive, unobtrusive, and real-time blood pressure (BP) monitoring remains elusive owing to BP’s complex dynamics. To bring this into fruition, several works have been conducted combining different biosignals to indirectly extract BP by using PTT. Unlike previous works, we considered PTT variability by averaging it over discrete durations to account for BP variability for a more accurate estimation. PTTs were obtained using electrocardiograph (ECG) and reflective photoplethysmograph (rPPG) signals extracted by a wearable device attached to a single site on the upper arm. Our results show a significant correlation between average PTT and the BP measured using auscultation in a trial study. The developed system has potential for chronic, noninvasive, and cuff-less blood pressure monitors (BPMs) for localized and single-site implementations. Meanwhile, real-time data from the wearable device may be accessed via a remote desktop or a mobile phone application.

Development of Real-Time Cuffless Blood Pressure Measurement Systems with ECG Electrodes and a Microphone Using Pulse Transit Time (PTT).

Research has shown that pulse transit time (PTT), which is the time delay between the electrocardiogram (ECG) signal and the signal from a photoplethysmogram (PPG) sensor, can be used to estimate systolic blood pressure (SBP) and diastolic blood pressure (DBP) without the need for a cuff. However, the LED of the PPG sensor requires the precise adjustment of both light intensity and light absorption rates according to the contact status of the light-receiving element. This results in the need for regular calibration. In this study, we propose a cuffless blood pressure monitor that measures real-time blood pressure using a microphone instead of a PPG sensor. The blood pulse wave is measured in the radial artery of the wrist using a microphone that can directly measure the sound generated by a body rather than sending energy inside the body and receiving a returning signal. Our blood pressure monitor uses the PTT between the R-peak of the ECG signal and two feature points of the blood pulse wave in the radial artery of the wrist. ECG electrodes and circuits were fabricated, and a commercial microelectromechanical system (MEMS) microphone was used as the microphone to measure blood pulses. The peak points of the blood pulse from the microphone were clear, so the estimated SBP and DBP could be obtained from each ECG pulse in real time, and the resulting estimations were similar to those made by a commercial cuff blood pressure monitor. Since neither the ECG electrodes nor the microphone requires calibration over time, the real-time cuffless blood pressure monitor does not require calibration. Using the developed device, blood pressure was measured three times daily for five days, and the mean absolute error (MAE) and standard deviation (SD) of the SBP and DBP were found to be 2.72 ± 3.42 mmHg and 2.29 ± 3.53 mmHg, respectively. As a preliminary study for proof-of-concept, these results were obtained from one subject. The next step will be a pilot study on a large number of subjects.

Non-contact Blood Pressure Measurement Method Using Frequency Modulated Continuous Wave Radar

Non-contact continuous blood pressure monitoring is significant in vital sign monitoring. Frequency modulated continuous wave (FMCW) radar is suitable for non-contact wave signal extraction. A heartbeat-guided blood pressure monitoring algorithm using FMCW radar is proposed. The target heart rate is detected and pulse wave signal is extracted based on FMCW reflected signals. The variational mode decomposition (VMD) is introduced to alleviate the interferences of human breath and slight body movements. The pulse wave signal is extracted based on target heart rate. Blood pressure related features of pure pulse waveform are extracted to obtain blood pressure based on its estimation model. Experiments are conducted indoor among 15 participants sitting in a nature state. The average accuracy of diastolic blood pressure (DBP) is 94.3% and that of systolic blood pressure is 94.4%. The experimental results demonstrate the robustness and effectiveness of the proposed algorithm, which makes it possible to further achieve long-term real-time non-contact blood pressure monitoring.

A Hardware-based Lightweight ANN for Real-time Wearable Blood Pressure Estimation.

Blood pressure (BP) is an important indicator of the state of cardiovascular health. BP estimation is an essential method to prevent the occurrence of hypertension. Currently, there is a strong focus on low power design for a wearable BP estimation device. This paper proposes a lightweight artificial neural network (ANN) for BP estimation and implements it on an ultra-low-power application-specific integrated circuit (ASIC). On the test set, the mean absolute error (MAE) and standard deviation (SD) of the estimated systolic BP and diastolic BP are 2.47 ± 3.48 mmHg and 1.45 ± 1.88 mmHg. Besides, in the case of 8-bit quantization, the MAE ± SD of the estimated systolic BP and diastolic BP are 12.41 ± 5.32 mmHg and 6.29 ± 3.03 mmHg respectively. The regression result R2 of overall SBP and DBP is 0.9702. This ASIC whose power is 19.72 µW is validated via the 0.18 µm CMOS process, occupying an area of 730 µmx 730 µm.

A Smart Solution for Cancer Patient Monitoring Based on Internet of Medical Things Using Machine Learning Approach.

The Internet of Medical Things (IoMT) is a huge, exciting new phenomenon that is changing the world of technology and innovating various industries, including healthcare. It has specific applications and changes in the medical world based on what can be done for clinical workflow models. The first and most fundamental thing that IoMT does in healthcare is to bring a flood of new data into medical processes. In this study, an efficient Internet of Medical Things based cancer detection model was proposed. In fact, for many, new fitness monitors and watches are one of the best examples on the Internet; these mobile, portable, wearable devices can record real-time heart rate, blood pressure, and eye movement of cancer patients. These details are sent to doctors or anywhere else. The proposed method leads to a kind of big data renaissance in the health service. The proposed model gets more accuracy while comparing with the existing models. This will help the doctors to analyze the patients' health report and provides better treatment.

Ultrasound-guided Radial Artery Cannulation

Arterial cannulation can be used to monitor blood pressure in real time and facilitate frequent arterial blood gas analysis.It is one of the commonly used clinical techniques in anesthesia,emergency,and intensive care units.Studies have demonstrated that ultrasound guidance can increase the success rate of arterial cannulation and reduce the incidence of related complications.In recent years,ultrasound guidance technology has developed rapidly and is increasingly used in clinical practice.This article reviews the latest advances in the application of ultrasound guidance in radial artery cannulation.

A robust and flexible pulse wave sensory array enabling real-time non-invasive blood pressure monitoring

Chronical cardiovascular decreases such as hypertension requires real-time and continuous monitoring of blood pressures (BPs). Pulse wave that contains critical and ample information on cardiovascular dynamics is a direct vital sign to extract BP and therefore an epidermal wearable device enabling real-time acquisition of pulse waves becomes necessary. In this work, we propose and study a flexible pulse wave sensory array aiming for real-time wearable pulse wave acquisition with robustness. A piezoelectric sensor together with a thin-film transistor-based sensor interface circuit is used to detect multiple pulse waveforms at the location of radial artery, which are input to a convolutional neural network for a deep-learning BP estimation model training. The estimated BPs are assessed by a correlation study with the BPs measured by conventional sphygmomanometers. Our study shows a reasonable accuracy of mean deviation and standard deviation of 2.84 ± 7.53 mmHg for systolic BP and 0.88 ± 7.06 mmHg for diastolic BP.

Reverse re-modelling chronic heart failure by reinstating heart rate variability

Heart rate variability (HRV) is a crucial indicator of cardiovascular health. Low HRV is correlated with disease severity and mortality in heart failure. Heart rate increases and decreases with each breath in normal physiology termed respiratory sinus arrhythmia (RSA). RSA is highly evolutionarily conserved, most prominent in the young and athletic and is lost in cardiovascular disease. Despite this, current pacemakers either pace the heart in a metronomic fashion or sense activity in the sinus node. If RSA has been lost in cardiovascular disease current pacemakers cannot restore it. We hypothesized that restoration of RSA in heart failure would improve cardiac function. Restoration of RSA in heart failure was assessed in an ovine model of heart failure with reduced ejection fraction. Conscious 24 h recordings were made from three groups, RSA paced (n = 6), monotonically paced (n = 6) and heart failure time control (n = 5). Real-time blood pressure, cardiac output, heart rate and diaphragmatic EMG were recorded in all animals. Respiratory modulated pacing was generated by a proprietary device (Ceryx Medical) to pace the heart with real-time respiratory modulation. RSA pacing substantially increased cardiac output by 1.4 L/min (20%) compared to contemporary (monotonic) pacing. This increase in cardiac output led to a significant decrease in apnoeas associated with heart failure, reversed cardiomyocyte hypertrophy, and restored the T-tubule structure that is essential for force generation. Re-instating RSA in heart failure improves cardiac function through mechanisms of reverse re-modelling; the improvement observed is far greater than that seen with current contemporary therapies. These findings support the concept of re-instating RSA as a regime for patients who require a pacemaker.

Real-Time Size-Fractioned Particulate Air Pollution and Blood Pressure Among Healthy Adults: A Repeated-Measure Panel Study

Real-Time Size-Fractioned Particulate Air Pollution and Blood Pressure Among Healthy Adults: A Repeated-Measure Panel Study

Impaired autonomic function after incomplete revascularisation

IntroductionIncomplete cardiac revascularisation (ICR) assessed by residual SYNTAX score (rSs) is associated with increased 5-year mortality. Furthermore, in the general population, our group has demonstrated that impaired autonomic function determined...