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Cuffless blood-pressure estimation method using a heart-rate variability-derived parameter
Yang Chen1,2, Shuo Shi3,2, Ying-Ke Liu1
1Department of Electronic and Information Engineering, Harbin Institute of Technology Shenzhen Graduate School, Shenzhen, People's Republic of China.
Insights
This study introduces a new cuffless blood pressure estimation method incorporating sympathetic tone, improving accuracy for hypertensive patients. The novel approach enhances non-invasive monitoring capabilities by integrating heart rate variability and pulse transit time.
Area of Science:
- Biomedical Engineering
- Cardiovascular Physiology
- Medical Devices
Background:
- Cuffless blood pressure (BP) monitoring offers potential for continuous, non-invasive BP assessment.
- Current cuffless methods face accuracy challenges, particularly in hypertensive individuals.
- Sympathetic tone variations are observed in hypertension, suggesting its relevance for BP estimation.
Purpose of the Study:
- To develop and validate a novel cuffless BP estimation method.
- To enhance BP estimation accuracy by incorporating sympathetic tone indicators.
- To evaluate the method's performance in both hypertensive and normotensive subjects.
Main Methods:
- Investigated heart-rate variability (HRV) and proposed the heart-rate power spectrum ratio (HPSR) as a sympathetic regulation indicator.
- Developed a BP estimation model integrating HPSR, pulse transit time (PTT), and photoplethysmography intensity ratio.
- Validated the model against standard sphygmomanometry in 60 participants (29 hypertensive, 31 normotensive).
Main Results:
- Hypertensive patients exhibited a significant increase in HPSR compared to normotensive subjects.
- Achieved estimation accuracy of ±10.04 mmHg for SBP and ±7.10 mmHg for DBP in hypertensive patients.
- The proposed method outperformed traditional PTT-based algorithms, reducing standard deviation error by 3 mmHg in hypertensive patients.
Conclusions:
- Integrating autonomic activity factors, such as sympathetic tone, improves cuffless BP estimation accuracy.
- The novel method shows promise for more reliable non-invasive BP monitoring, especially in hypertensive populations.
- This approach advances the development of practical clinical tools for long-term hypertension management.
Objective:
Cuffless blood-pressure (BP) estimation has attracted widespread interest owing to its potential for long-term, non-invasive BP monitoring. But it is still impractical in clinical settings, mainly owing to ongoing challenges with respect to accuracy in hypertensive patients. To better estimate the BP, the current study proposes a new cuffless estimation method that includes a sympathetic tone, which has been reported with a varied pattern in hypertensive patients.
Approach:
First, the heart-rate variability of all subjects is investigated, and a new parameter, the heart-rate power spectrum ratio (HPSR), is proposed to indicate BP dynamics under sympathetic regulation. Then, a new BP estimation model is constructed by integrating HPSP with the pulse transit time (PTT) and photoplethysmography intensity ratio. The estimation accuracy is further evaluated by making comparisons with the standard sphygmomanometer BP on 60 subjects (29 hypertensive and 31 normotensive).
Main Results:
A significant increase in HPSR was observed in hypertensive patients compared to normotensive subjects. Of the 60 subjects, the estimation accuracy was 0.73 ± 10.04 mmHg for systolic BP (SBP) and 0.90 ± 7.10 mmHg for diastolic BP (DBP) in hypertensive patients, which is comparable to 0.54 ± 7.52 mmHg for SBP and 0.82 ± 6.20 mmHg for DBP in normotensive subjects. Furthermore, the proposed method overperformed the traditional PTT-based algorithm by reducing the 3 mmHg error in the standard deviation in hypertensive patients.
Significance:
The results of the current study demonstrate that the inclusion of factors associated with autonomic activities in the BP estimation model would improve the BP estimation accuracy, especially for hypertensive subjects.
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