Beyond the Cuff: State-of-the-Art on Cuffless Blood Pressure Monitoring.

Area of Science:

• Biomedical Engineering
• Medical Devices
• Health Informatics

Background:

• Continuous blood pressure (BP) monitoring is vital for hypertension management and patient care.
• Traditional cuff-based BP monitoring methods are invasive, uncomfortable, and unsuitable for continuous tracking.

Purpose of the Study:

• To critically review emerging cuffless blood pressure (BP) monitoring technologies.
• To provide a unifying taxonomy of sensing modalities, measurement principles, and signal processing techniques.
• To identify challenges and future directions for scalable, explainable, and regulatory-compliant BP monitoring.

Main Methods:

• Survey of advanced cuffless BP monitoring technologies including radar, optical, acoustic, and capacitive sensors.
• Analysis of Machine Learning (ML) and sensor fusion approaches for enhanced predictive accuracy.
• Evaluation of methods addressing subject-specific calibration, motion artifacts, and international validation standards.

Main Results:

• Cuffless technologies offer potential for continuous, non-invasive BP estimation in remote health monitoring and ambient clinical intelligence.
• ML and sensor fusion enhance predictive accuracy, but clinical acceptability across diverse populations and real-world conditions remains a challenge.
• Performance benchmarks against gold standards are presented, highlighting current limitations.

Conclusions:

• Cuffless BP monitoring presents a promising alternative to traditional methods, with significant advancements in sensor technology and data analysis.
• Further research is crucial to overcome challenges in accuracy, generalizability, and regulatory compliance for widespread clinical adoption.
• Future systems should focus on scalability, explainability, and adherence to international validation standards.