mmHg For Diastolic Blood Pressure Research Articles

Contactless and Calibration-Free Blood Pressure and Pulse Rate Monitor for Screening and Monitoring of Hypertension: Cross-Sectional Validation Study.

The key to reducing the immense morbidity and mortality burdens of cardiovascular diseases is to help people keep their blood pressure (BP) at safe levels. This requires that more people with hypertension be identified, diagnosed, and given tools to lower their BP. BP monitors are critical to hypertension diagnosis and management. However, there are characteristics of conventional BP monitors (oscillometric cuff sphygmomanometers) that hinder rapid and effective hypertension diagnosis and management. Calibration-free, software-only BP monitors that operate on ubiquitous mobile devices can enable on-demand BP monitoring, overcoming the hardware barriers of conventional BP monitors. This study aims to investigate the accuracy of a contactless BP monitor software app for classifying the full range of clinically relevant BPs as hypertensive or nonhypertensive and to evaluate its accuracy for measuring the pulse rate (PR) and BP of people with BPs relevant to stage-1 hypertension. The software app, known commercially as Lifelight, was investigated following the data collection and data analysis methodology outlined in International Organization for Standardization (ISO) 81060-2:2018/AMD 1:2020 "Non-invasive Sphygmomanometers-Part 2: Clinical investigation of automated measurement type." This validation study was conducted by the independent laboratory Element Materials Technology Boulder (formerly Clinimark). The study generated data from 85 people aged 18-85 years with a wide-ranging distribution of BPs specified in ISO 81060-2:2018/AMD 1:2020. At least 20% were required to have Fitzpatrick scale skin tones of 5 or 6 (ie, dark skin tones). The accuracy of the app's BP measurements was assessed by comparing its BP measurements with measurements made by dual-observer manual auscultation using the same-arm sequential method specified in ISO 81060-2:2018/AMD 1:2020. The accuracy of the app's PR measurements was assessed by comparing its measurements with concurrent electroencephalography-derived heart rate values. The app measured PR with an accuracy root-mean-square of 1.3 beats per minute and mean absolute error of 1.1 (SD 0.8) beats per minute. The sensitivity and specificity with which it determined that BPs exceeded the in-clinic systolic threshold for hypertension diagnosis were 70.1% and 71.7%, respectively. These rates are consistent with those reported for conventional BP monitors in a literature review by The National Institute for Health and Care Excellence. The app's mean error for measuring BP in the range of normotension and stage-1 hypertension (ie, 65/85, 76% of participants) was 6.5 (SD 12.9) mm Hg for systolic BP and 0.4 (SD 10.6) mm Hg for diastolic BP. Mean absolute error was 11.3 (SD 10.0) mm Hg and 8.6 (SD 6.8) mm Hg, respectively. A calibration-free, software-only medical device was independently tested against ISO 81060-2:2018/AMD 1:2020. The safety and performance demonstrated in this study suggest that this technique could be a potential solution for rapid and scalable screening and management of hypertension.

The effect of physical activity intervention on blood pressure in 18 low and middle-income countries: a systematic review and meta-analysis of randomized controlled trials

BackgroundIn especially, low and middle-income nations (LMICs), where healthcare access may be restricted, high blood pressure (BP) is a major risk factor for cardiovascular disease and stroke, both of which can even lead to death. Altering one's lifestyle, in conjunction with medical therapy, has been demonstrated to be effective in lowering BP. Recent research has shown that physical activity (PA), in a variety of guises and to varying degrees, can be an effective means of lowering BP.ObjectiveThe purpose of this meta-analysis and systematic review was to evaluate the impact that PA plays in the development of hypertension in LMICs nations.MethodsAn exhaustive search of the available research was carried out in order to locate studies that were pertinent. We searched a number of online databases, such as SCOPUS, Medline, and Web of Science, looking for clinical trials that were published before March of 2023. Studies were only considered for inclusion if they were randomized controlled trials (RCTs), reported on the association between PA and BP, and were carried out in LMICs countries.ResultsThis meta-analysis incorporated a comprehensive collection of 60 studies, encompassing a total of 11,002 people, consisting of 5,630 cases and 5372 controls. The findings indicate that engaging in PA had a notable impact on decreasing systolic blood pressure (SBP), as seen by a weighted mean difference (WMD) of -7.70 mmHg, with a 95% confidence interval (CI) ranging from -9.50 to -5.91 (p < 0.001). Additionally, PA was found to have a significant influence on reducing diastolic blood pressure (DBP), as indicated by a WMD of -3.60 mmHg, with a 95% CI ranging from -4.48to -2.73(p < 0.001). The findings from subgroup analysis indicate that the observed results remained statistically significant when considering individuals with baseline SBP of 120 mmHg or lower and DBP of 80 mmHg or lower.ConclusionThe incorporation of PA can significantly contribute to the mitigation of high BP within LMICs nations. Additional investigation is required to ascertain the most effective form and amount of PA in order to mitigate BP levels within these specific individuals.Graphical

Home blood pressure-lowering effect of a non-steroidal mineralocorticoid receptor blocker, esaxerenone, versus trichlormethiazide for uncontrolled hypertension: the EXCITE-HT randomized controlled study.

The EXCITE-HT study aimed to evaluate the efficacy and safety of esaxerenone versus thiazide diuretics (trichlormethiazide) as second-line treatment for Japanese patients with uncontrolled essential hypertension. This was a 12-week, multicenter, randomized, open-label, parallel-group study. The non-inferiority of esaxerenone to trichlormethiazide was confirmed if the upper limit of the two-sided 95% confidence interval (CI) for the difference in systolic blood pressure (SBP)/diastolic blood pressure (DBP) change between groups was below 3.9/2.1 mmHg. A total of 295 and 290 patients were included in the esaxerenone and trichlormethiazide groups, respectively. The non-inferiority of esaxerenone to trichlormethiazide was demonstrated: least squares mean change differences in morning home SBP/DBP at end of treatment (EOT) were -2.2 (95% CI, -3.6, -0.8) mmHg for SBP/-0.6 (-1.4, 0.2) mmHg for DBP. Morning home, bedtime home, and office BP significantly decreased (all p < 0.001) from baseline to EOT in both groups. The urinary albumin-to-creatinine ratio and N-terminal pro-brain natriuretic peptide level decreased from baseline to Week 12 in both groups, with no notable intergroup difference. Serum potassium elevations occurred more frequently with esaxerenone, while serum potassium reductions occurred more with trichlormethiazide. Uric acid elevations were observed in both groups, but more frequently with trichlormethiazide than esaxerenone. No cases of gout occurred in this study. Reductions in estimated glomerular filtration rate were similarly observed in both groups. EXCITE-HT is the first randomized controlled study to demonstrate evidence that esaxerenone is non-inferior to trichlormethiazide as second-line treatment for Japanese patients with uncontrolled essential hypertension, with no new safety concerns. The EXCITE-HT study demonstrated the non-inferiority of esaxerenone to trichlormethiazide in its morning home blood pressure lowering effect and safety profile in Japanese patients with uncontrolled essential hypertension who were previously treated with an angiotensin II receptor blocker or calcium channel blocker.

Effects of Oral Butyrate on Blood Pressure in Patients With Hypertension: A Randomized, Placebo-Controlled Trial.

The microbiota-derived short chain fatty acid butyrate has been shown to lower blood pressure (BP) in rodent studies. Nonetheless, the net effect of butyrate on hypertension in humans remains uncovered. In this study, for the first time, we aimed to determine the effect of oral butyrate on BP in patients with hypertension. We performed a double-blind randomized placebo-controlled trial including 23 patients with hypertension. Antihypertensive medication was discontinued for the duration of the study with a washout period of 4 weeks before starting the intervention. Participants received daily oral capsules containing either sodium butyrate or placebo with an equivalent dosage of sodium chloride for 4 weeks. The primary outcome was daytime 24-hour systolic BP. Differences between groups over time were assessed using linear mixed models (group-by-time interaction). Study participants (59.0±3.7 years; 56.5% female) had an average baseline office systolic BP of 143.5±14.6 mm Hg and diastolic BP of 93.0±8.3 mm Hg. Daytime 24-hour systolic and diastolic BP significantly increased over the intervention period in the butyrate compared with the placebo group, with an increase of +9.63 (95% CI, 2.02-17.20) mm Hg in daytime 24-hour systolic BP and +5.08 (95% CI, 1.34-8.78) mm Hg in diastolic BP over 4 weeks. Butyrate levels significantly increased in plasma, but not in feces, upon butyrate intake, underscoring its absorption. Four-week treatment with oral butyrate increased daytime systolic and diastolic BP in subjects with hypertension. Our findings implicate that butyrate does not have beneficial effects on human hypertension, which warrants caution in future butyrate intervention studies. URL: https://clinicaltrialregister.nl/nl/trial/22936; Unique identifier: NL8924.

Cardiac Follow up of Pediatric Patients Presented with Covid-19 Cardiovascular Affection

Abstract Background Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection is typically very mild and often asymptomatic in children. A complication is the rare multisystem inflammatory syndrome in children (MIS-C) associated with COVID-19 carditis, presenting 4–6 weeks after infection as high fever, organ dysfunction, and strongly elevated markers of inflammation. Aim of the Work To Follow up of Pediatric Patients Presented with Covid-19 Cardiovascular Affection. Patients and Methods This was an analytical Prospective Cohort study conducted on 33 patients with post COVID-19 infection. all patients were subjected to the following:(demographic data, clinical signs &amp; symptoms, laboratory investigations and Echocardiogrsphy at presentation, 1,6 weeks and 3months follow up from January 2021 to August 2021 to evaluate the short and mid- term effect of COVID-19 infection on cardiac function, and outcomes for pediatric multisystem inflammatory syndrome related to covid-19. Results In our study all patients fulfilled criteria of MIS-C presented with Kawasaki disease(KD)- like symptoms and gastrointestinal symptoms in addition to fever with shock or cardiac dysfunction. Our patients were presented with the following vital data: tacycardia with mean of 132.82 (18.74) beat/minute, hypotension with mean of 88.03 (14.06) (mmhg) for systolic blood pressure &amp; mean of 49.39 (14.78) mmhg for diastolic blood pressure, spo2 mean 96.27 (2) %, high grade fever of mean 38.36(0.79). KD-like features were seen in many patients (skin rash in 66.7%, conjunctivitis in 75.8% and Cardiovascular abnormalities were seen in 100% e.g. (myocardial dysfunction, valvular regurgitation, pericardial effusion and shock. Our MIS-C patients had signs and symptoms of an inflammatory state e.g.(fever, rash, conjunctivitis and diarrhea(gastroenteritis). Conclusion MIS-C is a hyper-infammatory syndrome affecting multiple organs especially the heart and is triggered by SARS-CoV-2 infection. It is usually seen 2–4 weeks following infection. In our study,IVIG and steroids might have a beneficial role in MIS-C management.

HGCTNet: Handcrafted Feature-Guided CNN and Transformer Network for Wearable Cuffless Blood Pressure Measurement.

Biosignals collected by wearable devices, such as electrocardiogram and photoplethysmogram, exhibit redundancy and global temporal dependencies, posing a challenge in extracting discriminative features for blood pressure (BP) estimation. To address this challenge, we propose HGCTNet, a handcrafted feature-guided CNN and transformer network for cuffless BP measurement based on wearable devices. By leveraging convolutional operations and self-attention mechanisms, we design a CNN-Transformer hybrid architecture to learn features from biosignals that capture both local information and global temporal dependencies. Then, we introduce a handcrafted feature-guided attention module that utilizes handcrafted features extracted from biosignals as query vectors to eliminate redundant information within the learned features. Finally, we design a feature fusion module that integrates the learned features, handcrafted features, and demographics to enhance model performance. We validate our approach using two large wearable BP datasets: the CAS-BP dataset and the Aurora-BP dataset. Experimental results demonstrate that HGCTNet achieves an estimation error of 0.9 ± 6.5 mmHg for diastolic BP (DBP) and 0.7 ± 8.3 mmHg for systolic BP (SBP) on the CAS-BP dataset. On the Aurora-BP dataset, the corresponding errors are -0.4 ± 7.0 mmHg for DBP and -0.4 ± 8.6 mmHg for SBP. Compared to the current state-of-the-art approaches, HGCTNet reduces the mean absolute error of SBP estimation by 10.68% on the CAS-BP dataset and 9.84% on the Aurora-BP dataset. These results highlight the potential of HGCTNet in improving the performance of wearable cuffless BP measurements.

Validating the Accuracy of Omron HEM-1026 (HCR-1901T2/HCR-1902T2): Blood Pressure Monitoring Device at Home, According to the Universal Protocol.

The performance of Omron HEM-1026 (HCR-1901T2 / HCR-1902T2) for monitoring blood pressure (BP) in the upper arm was validated in accordance with the International Organization for Standardization (ISO) 81060-2:2018+amendment (Amd)1:2020 protocol. The device was assessed in 101 participants who fulfilled the inclusion criteria, including arm circumference range and systolic and diastolic BP provided by the protocol. Data validation and analysis were performed according to the manufacturer's instructions. In the ISO 81060-2:2018+Amd 1:2020 validation procedure (criterion 1), the mean ± standard deviation (SD) of the differences between the test device and reference BP was -2.1 ± 7.24/-0.6 ± 5.63 mmHg (systolic/diastolic). These data fulfilled the ISO81060-2:2018+Amd1:2020 requirement of ≤5±≤8 mmHg. The mean differences between the two observers and Omron HEM-1026 were -2.1 ± 5.71 mmHg for systolic BP and -0.6 ± 4.81 mmHg for diastolic BP, fulfilling criterion 2 with an SD of ≤ 6.62 for systolic BP and ≤ 6.91 for diastolic BP. The two ISO criteria were fulfilled. The Omron HEM-1026 BP monitor fulfilled the requirements of the ISO 81060-2:2018+Amd 1:2020 validation standard and can be recommended for home BP measurements in the general population.

On Univariate Gaussian Mixture Model for Diabetic Patients in Yola, Adamawa State

Finite Mixture Model serves as a potent statistical tool for modeling intricate data distributions through the amalgamation of multiple Gaussian components. The aim of this work is to use finite mixture of normal distribution to model data on diabetic patients from Modibbo Adama University Teaching Hospital, Yola, Adamawa State, so as to expose latent sub-groups. The model is first used on synthetic data and subsequently on diabetic patients data. The diabetic data set consists of 553 cases of diabetes mellitus. The variables measured: Age(years), Mass of a patient(kg/meters), glucose level (plasma glucose con- centration, a 2-hour in an oral glucose tolerance test), pressure (Diastolic blood pressure mmHg), insulin (2-hour serum insulin mu U/ml) and class variable (0 or 1) treating 0 as false or negative and 1 treated as true or positive test for diabetes. The synthetic data is obtained from Gaussian distribution. The results showed that there is presence of heterogeneity in the data by showing the presence of 2 sub-groups.

Pulse pressure modifies the association between diastolic blood pressure and decrease in kidney function: The Japan Specific Health Checkups Study

Abstract Background Unlike systolic blood pressure (SBP), the prognostic value of diastolic blood pressure (DBP) in kidney function has not been established. We hypothesized that pulse pressure (PP), which is associated with arteriosclerosis, would affect the prognostic value of DBP. Methods This longitudinal study used data from the Japan Specific Health Checkups Study conducted between 2008 and 2014. The participants were stratified into 3 PP subgroups (low-PP ≤ 39, normal-PP 40–59, and high-PP ≥60 mmHg). The exposures of interest were SBP and DBP, and the association between SBP/DBP and kidney outcomes (30% decline in the estimated glomerular filtration rate from baseline) was examined in each PP subgroup using a Cox proportional hazards model. Results Among 725 022 participants, 20 414 (2.8%) developed kidney outcomes during a median follow-up period of 34.6 months. Higher SBP was consistently associated with a higher incidence of kidney outcome in all PP subgroups. Although DBP had a positive linear association with the incidence of kidney outcome in low- and normal-PP subgroups, both lower (≤60 mmHg) and higher (≥101 mmHg) DBP were associated with a higher incidence of kidney outcome in high-PP subgroup with U-shaped curve. Hazard ratios (95% confidence intervals) of ≤60 mmHg (reference: 61-80 mmHg in normal-PP subgroup) and ≥101 mmHg were 1.26 (1.15–1.38) and 1.86 (1.62–2.14), respectively. Conclusions In this large population-based cohort, DBP was differently associated with kidney outcome by PP levels; lower DBP was significantly associated with a higher incidence of kidney outcome in high-PP subgroup but not in low- and normal-PP subgroups.

#2649 Blood pressure tend to decrease following COVID-19 infection in patients with chronic kidney disease—lessons learned from a community based cohort

Abstract Background and Aims Pre-existing hypertension (HTN) has been implicated as one of the most common co-morbidities in COVID-19 patients, likely contributing to disease severity. Additionally, the port of viral entry to the host cell—ACE2 receptor, which is a part of the renin-angiotensin-aldosterone system, was initially thought to cause blood pressure (BP) dysregulation. Recently, several large cohorts have been published, connecting COVID-19 infection to new-onset HTN. Nevertheless, the association of HTN with COVID-19 in patients with chronic kidney disease (CKD) in a community setting has not been fully elucidated. We aimed to study the effect of COVID-19 infection on BP in patients with CKD. Method In this cohort study we utilized the Maccabi Healthcare Services (MHS) database during the COVID-19 pandemic. MHS is a nationwide health care payer-provider, providing health services to approximately 2.6 million Israelis. Data is automatically collected and includes comprehensive laboratory results from a single central lab, full pharmacy prescription and purchase data, physician visits, vital signs documentation, imaging and extensive demographic information on each patient. The database includes several automatically formulated registries including a well validated CKD registry. On July 31st 2023 we looked at point prevalence of patients registered as having CKD stages I-V, defined as eGFR &amp;lt;60 ml/min and/or albuminuria over 30 mg on 24 hour urine collection or 30 mg/g creatinine on urine albumin to creatinine ratio, or proteinuria above 150 mg either at spot urine protein to creatinine ratio or over 24 hour collection. We included CKD patients over the age of 18 years, who had mostly mild COVID-19 disease, detected by SARS-CoV-2 PCR or antigen test between January 1st 2020 and December 31st 2022. Examinees were included only if they had at least one blood pressure measurement documented, in their primary care clinic, in the year prior to infection, and at least one measurement during the 12 months period following COVID-19. Only the 1st documented COVID-19 infection of each patient was included. We compared the differences in BP values between pre and post COVID-19. Results Out of 1,821,685 adults at Maccabi HMS in 2023, 193,566 patients were registered as having CKD. Of those, 86,618 had a documented first COVID-19 infection between the years 2020-2022, and 44,410 of them had documented BP measurements both prior and after COVID-19 were analyzed. Mean age for all CKD patients who had COVID-19 was 69.2 (SD-12.9) years and 22,151 (49.9%) were males. Most patients had CKD stage III—26,939 (60%), and 535 (1.2%) were on dialysis. Not surprisingly, 76% of CKD patients had a preexisting diagnosis of HTN and 44% had diabetes mellitus. Average BP values during the year prior to COVID-19 were 133/76.5 mmHg (SD 14.8 and 8.55, respectively). Mean BP values post COVID-19 were 132/75/9 mmHg (SD 15.5 and 8.9, respectively). This translates into a reduction of 1 mmHg in systolic BP and 0.6 mmHg in diastolic BP in the year prior to COVID-19 infection as compared with pre-covid-19 infection (P-value 0.03 and 0.004, respectively). Conclusion Contrary to previous studies, that linked COVID-19 infection to a higher set-point of BP, our data demonstrates in a large community-based cohort of CKD patients, that BP does not increase and even trends down following COVID-19. As patients were one year older during their post-covid year, and some had withdrew ACE inhibitors or ARB, due to erroneous fear of adverse effect on Covid-19 infectivity, we believe that our results may even underestimate the extent of decrease in BP. Further investigation might reveal the possible mechanisms related to this favorable BP decrease after COVID-19 infection, in CKD patients.

Validating the accuracy of Omron HEM-7372T1-AZAZ (BP5460) in monitoring blood pressure according to the ISO 81060-2:2018+Amd 1:2020 protocol in the general population.

The performance of the Omron HEM-7372T1-AZAZ (BP5460) in monitoring blood pressure (BP) in the upper arm was validated in accordance with the International Organization for Standardization (ISO) 81060-2:2018 (E) and amendment (Amd)1:2020 protocol. The device was used to assess 98 participants who fulfilled the inclusion criteria, including the range of arm circumference and systolic and diastolic BP, in accordance with the protocol. Data validation and analysis were performed according to the manufacturer's instructions. In the ISO validation procedure (criterion 1), the mean ± SD of the differences between test device readings and reference BP was 0.3 ± 6.17/3.6 ± 5.26 mmHg (systolic/diastolic). These data fulfilled the ISO requirements of ≤5±≤8 mmHg. The mean differences between the observer measurements and Omron HEM-7372T1-AZAZ (BP5460) readings were 0.3 ± 4.82 mmHg for systolic BP and 3.6 ± 4.78 mmHg for diastolic BP, fulfilling criterion 2 with SD values of ≤6.95 for SBP and ≤5.89 for DBP. Therefore, two ISO criteria were fulfilled. The Omron HEM-7372T1-AZAZ BP monitor fulfilled the requirements of the ISO validation standard. This device can be recommended for home BP measurements in the general population.

Non-linear association and benchmark dose of blood pressure on carotid artery intima-media thickening in a general population of southern China.

This study aimed to evaluate whether there is a J-curve association between blood pressure (BP) and carotid artery intima-media thickening (CAIT) and estimate the effect of the turning point of BP on CAIT. Data from 111,494 regular physical examinations conducted on workers and retirees (aged 18 years or older) between January 2011 and December 2016, exported from the hospital information system, were analyzed. Restricted cubic splines (RCS) logistic regression was employed to access the association of BP with CAIT, and Bayesian benchmark dose methods were used to estimate the benchmark dose as the departure point of BP measurements. All the pnon-linear values of BP measurements were less than 0.05 in the RCS logistic regression models. Both systolic blood pressure (SBP) and diastolic blood pressure (DBP) had J-curve associations with the risk of CAIT at a turning point around 120/70 mmHg in the RCS. The benchmark dose for a 1% change in CAIT risk was estimated to be 120.64 mmHg for SBP and 72.46 mmHg for DBP. The J-curve associations between SBP and DBP and the risk of CAIT were observed in the general population in southern China, and the turning point of blood pressure for significantly reducing the risk of CAIT was estimated to be 120.64/72.46 mmHg for SBP/DBP.

The association of hypertension among married Indian couples: a nationally representative cross-sectional study

Mounting evidence demonstrates that intimate partners sharing risk factors have similar propensities for chronic conditions such as hypertension. The objective was to study whether spousal hypertension was associated with one’s own hypertension status independent of known risk factors, and stratified by socio-demographic subgroups (age, sex, wealth quintile, caste endogamy). Data were from heterosexual married couples (n = 50,023, women: 18–49 years, men: 21–54 years) who participated in the National Family Health Survey-V (2019–2021). Hypertension was defined as self-reported diagnosis of hypertension or average of three blood pressure measurements ≥ 140 systolic or 90 mmHg diastolic BP. Among married adults, the prevalence of hypertension among men (38.8 years [SD 8.3]) and women (33.9 years [SD 7.9]) were 29.1% [95% CI 28.5–29.8] and 20.6% [95% CI 20.0–21.1] respectively. The prevalence of hypertension among both partners was 8.4% [95% CI 8.0–8.8]. Women and men were more likely to have hypertension if their spouses had the condition (husband with hypertension: PR 1.37 [95% CI 1.30–1.44]; wife with hypertension: PR 1.32 [95% CI 1.26–1.38]), after adjusting for known risk factors. Spouse’s hypertension status was consistently associated with own status across all socio-demographic subgroups examined. These findings present opportunities to consider married couples as a unit in efforts to diagnose and treat hypertension.

EVALUATION OF A PROTOTYPE CUFFLESS MULTI-SENSOR DEVICE TO TRACK BLOOD PRESSURE CHANGES

Objective: Accurate measurements are essential if cuffless blood pressure (BP) devices are to be used in hypertension care. The aim of the present study was to evaluate the ability of a prototype cuffless device (XXXXX) to track changes in BP compared to a non-invasive, continuous BP monitor (reference BP; Human NIBP Nano system, ADInstruments, Dunedin, New Zealand) in an experimental laboratory set up. Design and method: After ethical approval, three external techniques (Figure 1) to induce BP changes via different physiological mechanisms, were applied in 23 healthy subjects. Continuous data from the prototype cuffless device on the upper arm was obtained simultaneously with reference BP measurements. The cuffless device measures skin temperature, 3D acceleration, 3D angular velocity and photoplethysmography. Data from 16 of the participants were used to train a machine learning model, which was then used to estimate BP (15-second resolution) on data from 7 other participants. The cuffless BP device was calibrated once using brachial cuff BP measurement (WatchBP O3, Microlife, Cambridge, United Kingdom). The present study provides preliminary results from a larger on-going study designed to evaluate performance of the cuffless device according to ISO 81060-3:2022 standard. Results: A timeseries plot displaying BP measurements from the cuffless and the reference device is displayed in Figure 2. The mean error (± corrected standard deviation of error) was 2.4 (± 7.9) mmHg for systolic blood pressure (SBP) and 1.7 (± 7.4) mmHg for diastolic blood pressure (DBP) for the accuracy requirement. The corresponding errors for stability requirements were 1.9 (± 8.1) and 1.9 (± 6.0) mmHg for SBP and DBP. Conclusions: The present study demonstrated that the prototype cuffless BP device could track BP changes with high accuracy in healthy subjects in a laboratory setting. The cuffless device fulfilled the acceptance criteria (± 6 (± 10) mmHg) for the accuracy and stability requirements from the ISO 81060-3:2022 standard. Further research is necessary to determine accuracy of the prototype cuffless BP device during real-life conditions as described in the 2023 ESH recommendations for the validation of cuffless devices.

MEMS Fingertip Strain Plethysmography for Cuffless Estimation of Blood Pressure.

To develop a cuffless method for estimating blood pressure (BP) from fingertip strain plethysmography (SPG) recordings. A custom-built micro-electromechanical systems (MEMS) strain sensor is employed to record heartbeat-induced vibrations at the fingertip. An XGboost regressor is then trained to relate SPG recordings to beat-to-beat systolic BP (SBP), diastolic BP (DBP), mean arterial pressure (MAP) values. For this purpose, each SPG segment in this setup is represented by a feature vector consisting of cardiac time interval, amplitude features, statistical properties, and demographic information of the subjects. In addition, a novel concept, coined geometric features, are introduced and incorporated into the feature space to further encode the dynamics in SPG recordings. The performance of the regressor is assessed on 32 healthy subjects through 5-fold cross-validation (5-CV) and leave-subject-out cross validation (LSOCV). Mean absolute errors (MAEs) of 3.88 mmHg and 5.45 mmHg were achieved for DBP and SBP estimations, respectively, in the 5-CV setting. LSOCV yielded MAEs of 8.16 mmHg for DBP and 16.81 mmHg for SBP. Through feature importance analysis, 3 geometric and 26 integral-related features introduced in this work were identified as primary contributors to BP estimation. The method exhibited robustness against variations in blood pressure level (normal to critical) and body mass index (underweight to obese), with MAE ranges of [1.28, 4.28] mmHg and [2.64, 7.52] mmHg, respectively. The findings suggest high potential for SPG-based BP estimation at the fingertip. This study presents a fundamental step towards the augmentation of optical sensors that are susceptible to dark skin tones.

A Ten Year Experience of Men's Health Events in a Socioeconomically Diverse City in the United States - Lessons Learned.

Community-based health events provide an opportunity to increase knowledge, awareness, and screening for acute and chronic diseases among individuals living in a socioeconomically diverse community. Because there are limited reports of such events, here we describe our ten-year experience of annual men's health fairs. This retrospective study of the Michigan Institute of Urology Foundation evaluated Men's Health Events held in Detroit, Michigan, from 2012 to 2021. Over 10 years, 11,129 men were screened and > 100,000 screenings were performed. The majority of the attendees were African-American men (61%), had a college degree (67%) or a high school diploma (26%), and had an annual income of <$35K (47%) or $35-60K (30%). From 2012 to 2021,participants who saw a doctor in the past year rose from 62 to 70%; the median age of men rose from 52 to 58; their median testosterone levels increased from 353 ng/dL to 412 ng/dL, and men with concerning prostate-specific antigen values (≥ 4 ng/mL) doubled from 5% to 10%. Among participants, 59% had cholesterol levels of < 200mg/dL, 28% of 200-240mg/dL, and 13% of > 240mg/dL; 7% had glucose levels of < 70mg/dL, 68% of 70-105mg/dL, and 25% of > 105mg/dL ; 24% had ≥ 140 mmHg systolic and 18% had ≥ 90 mmHg diastolic blood pressure. Our findings suggest that community health events are successful at attracting and screening diverse community members. Such events should emphasize screening of high-risk individuals for acute and chronic diseases and promote other health-related behaviors.

UbiHeart: A novel approach for non-invasive blood pressure monitoring through real-time facial video

Monitoring blood pressure (BP) is an essential component of evaluating cardiovascular health, aiding in the early detection and management of hypertension-related complications. Traditional methods of BP measurement often involve invasive or cumbersome devices, leading to discomfort and reduced compliance. We propose a framework to monitor BP non-invasively, analyzing the face video captured by a webcam or smartphone camera leveraging the relationship of image-based Pulse Transit Time (iPTT) and Heart Rate Variability (HRV) with BP. We have built a dataset of 90 sets of collected videos using a mobile phone front camera and BP data from a standard digital BP monitor from 12 individuals from an approved Institutional Review Board (IRB) to evaluate our system. We have got a Mean Absolute Error (MAE) of 10.35+/−2.5 mmHg for systolic BP (SBP) and 7.8+/−1.5 mmHg for diastolic BP (DBP) while using the HRV representation RMSSD. On the other hand, an MAE of 8.25+/−3.5 mmHg for SBP and 7.7+/−2.5 mmHg for DBP while using the HRV representation SDRR. Finally, we have developed a framework and built a real-time system to monitor BP as a mobile and web-based application that can facilitate early detection of trends and anomalies, allowing healthcare providers to intervene promptly and personalize treatment plans.

Evaluation of vital signs through a mobile application in patients with heart failure: a opportunity for remote titration?

Virtual consultations have increased exponentially, but a limitation is the inability to assess vital signs (VS). This is particularly useful in patients with heart failure (HF) for titrating prognosis-modifying medication. This issue could potentially be addressed by a tool capable of measuring blood pressure (BP) and heart rate (HR) accurately, remotely, and conveniently. Mobile phones equipped with transdermal optical imaging technology could meet these requirements. To evaluate the accuracy of a transdermal optical imaging-based app for estimating VS compared to clinical assessment in patients with HF. A prospective cohort study included patients evaluated in an HF outpatient unit between February and April 2022. BP and HR were simultaneously assessed using the app and clinical examination (BP with an automated sphygmomanometer and HR by brachial palpation). Three measurements were taken by both the app and clinic for each patient, by two independent blinded physicians. Thirty patients were included, with 540 measurements of BP and HR. The mean age was 66 (± 13) years, 53.3% were male. The mean left ventricular ejection fraction was 37 ± 15, with 63.3% having previous hospitalizations for HF, and 63.4% in NYHA class II-III. The mean difference between the app measurement and its clinical reference measurement was 3.6 ± 0.5 mmHg for systolic BP (SBP), 0.9 ± -0.2 mmHg for diastolic BP (DBP), and 0.2 ± 0.4 bpm for HR. When averaging the paired mean differences for each patient, the mean across the 30 patients was 2 ± 6 mmHg for SBP, -0.14 ± 4.6 mmHg for DBP, and 0.23 ± 4 bpm for HR. The estimation of BP and HR by an app with transdermal optical imaging technology was comparable to non-invasive measurement in patients with HF and met the precision criteria for BP measurement in this preliminary study. The use of this new transdermal optical imaging technology provides promising data, which should be corroborated in larger cohorts.

Susceptibility of hypertensive individuals to acute blood pressure increases in response to personal-level environmental temperature decrease

BackgroundEnvironmental temperature is negatively associated with blood pressure (BP), and hypertension may exacerbate this association. The aim of this study is to investigate whether hypertensive individuals are more susceptible to acute BP increases following temperature decrease than non-hypertensive individuals. MethodsThe study panel consisted of 126 hypertensive and 125 non-hypertensive (n = 251) elderly participants who completed 940 clinical visits during the winter of 2016 and summer of 2017 in Beijing, China. Personal-level environmental temperature (PET) was continuously monitored for each participant with a portable sensor platform. We associated systolic BP (SBP) and diastolic BP (DBP) with the average PET over 24 h before clinical visits using linear mixed-effects models and explored hourly lag patterns for the associations using distributed lag models. ResultsWe found that per 1 °C decrease in PET, hypertensive individuals showed an average (95 % confidence interval) increase of 0.96 (0.72, 1.19) and 0.28 (0.13, 0.42) mmHg for SBP and DBP, respectively; and non-hypertensive participants showed significantly smaller increases of 0.28 (0.03, 0.53) mmHg SBP and 0.14 (-0.01, 0.30) mmHg DBP. A lag pattern analysis showed that for hypertensive individuals, the increases in SBP and DBP were greatest following lag 1 h PET decrease and gradually attenuated up to lag 10 h exposure. No significant BP change was observed in non-hypertensive individuals associated with lag 1–24 h PET exposure. The enhanced increase in PET-associated BP in hypertensive participants (i.e., susceptibility) was more significant in winter than in summer. ConclusionsWe found that a decrease in environmental temperature was associated with acute BP increases and these associations diminished over time, disappearing after approximately 10 hours. This implies that any intervention measures to prevent BP increases due to temperature drop should be implemented as soon as possible. Such timely interventions are particularly needed for hypertensive individuals especially during the cold season due to their increased susceptibility.

Contactless Blood Pressure Measurement Via Remote Photoplethysmography With Synthetic Data Generation Using Generative Adversarial Networks.

Remote photoplethysmography (rPPG) has been used to measure vital signs such as heart rate, heart rate variability, blood pressure (BP), and blood oxygen. Recent studies adopt features developed with photoplethysmography (PPG) to achieve contactless BP measurement via rPPG. These features can be classified into two groups: time or phase differences from multiple signals, or waveform feature analysis from a single signal. Here we devise a solution to extract the time difference information from the rPPG signal captured at 30 FPS. We also propose a deep learning model architecture to estimate BP from the extracted features. To prevent overfitting and compensate for the lack of data, we leverage a multi-model design and generate synthetic data. We also use subject information related to BP to assist in model learning. For real-world usage, the subject information is replaced with values estimated from face images, with performance that is still better than the state-of-the-art. To our best knowledge, the improvements can be achieved because of: 1) the model selection with estimated subject information, 2) replacing the estimated subject information with the real one, 3) the InfoGAN assistance training (synthetic data generation), and 4) the time difference features as model input. To evaluate the performance of the proposed method, we conduct a series of experiments, including dynamic BP measurement for many single subjects and nighttime BP measurement with infrared lighting. Our approach reduces the MAE from 15.49 to 8.78 mmHg for systolic blood pressure (SBP) and 10.56 to 6.16 mmHg for diastolic blood pressure(DBP) on a self-constructed rPPG dataset. On the Taipei Veterans General Hospital(TVGH) dataset for nighttime applications, the MAE is reduced from 21.58 to 11.12 mmHg for SBP and 9.74 to 7.59 mmHg for DBP, with improvement ratios of 48.47% and 22.07% respectively.