Bilateral cuff-induced lower limb post-ischemia hyperemia as a method for acute reduction in blood pressure for cuffless blood pressure device testing

Mark Butlin; James R. Cox; Isabella Tan; Alberto P. Avolio; Gisele J. Bentley

doi:10.1109/EMBC40787.2023.10341156

Bilateral cuff-induced lower limb post-ischemia hyperemia as a method for acute reduction in blood pressure for cuffless blood pressure device testing

Mark Butlin, James R. Cox, Isabella Tan, Alberto P. Avolio, Gisele J. Bentley

Macquarie Medical School

Research output: Chapter in Book/Report/Conference proceeding › Conference proceeding contribution › peer-review

Abstract

Objective: Development and testing of cuffless blood pressure (BP) devices requires methods to increase and decrease BP. This is also required by cuffless BP validation standards. Pharmacological interventions, whilst successful, are not always feasible for all subpopulations or research settings. Non-pharmacological approaches for increasing BP are available, however, methods for decreasing BP are not well described. This study investigates the hyperemic response following bilateral leg-cuff ischemia as a method for acute BP lowering.

Design and Method: Participants (n=8, 24±8 years, 6 female) had their BP measured by continuous (finger, Peňáz technique) and intermittent (brachial cuff, oscillometric) methods before, during and following 3-minute leg-ischemia with the participant in an upright position. Total peripheral resistance (TPR) and cardiac output (CO) were calculated from finger BP waveforms. Maxima and minima responses in the variables were extracted and compared to resting conditions by repeated measures analysis of covariance.

Results: During the hyperemic period, systolic BP decreased by -22±3 mmHg (finger) and -6±1 mmHg (brachial). Diastolic BP decreased by -14±5 mmHg (finger) and -4 ±1 mmHg (brachial). Calculated TPR and CO varied, with both decreasing by half and almost doubling during the hyperemic response period.

Conclusions: Leg-cuff ischemia provides a controlled, non-pharmacological intervention for decreasing systemic arterial BP. This removes some of the limitations in testing, development and validation of cuffless BP techniques and devices.

Original language	English
Title of host publication	2023 45th Annual International Conference of the IEEE Engineering in Medicine & Biology Conference (EMBC)
Subtitle of host publication	Proceedings
Place of Publication	USA
Publisher	Institute of Electrical and Electronics Engineers (IEEE)
Number of pages	4
ISBN (Electronic)	9798350324471
ISBN (Print)	9798350324488
DOIs	https://doi.org/10.1109/EMBC40787.2023.10341156
Publication status	Published - 1 Jul 2023
Event	Annual International Conference of the IEEE Engineering in Medicine and Biology Conference (45th : 2023) - Sydney, Australia Duration: 24 Jul 2023 → 27 Jul 2023

Publication series

Name	Annual International Conference of the IEEE Engineering in Medicine and Biology Society
Publisher	Institute of Electrical and Electronics Engineers (IEEE)
ISSN (Electronic)	2694-0604

Name
Volume	2023

Conference

Conference	Annual International Conference of the IEEE Engineering in Medicine and Biology Conference (45th : 2023)
Abbreviated title	EMBC 2023
Country/Territory	Australia
City	Sydney
Period	24/07/23 → 27/07/23

Keywords

Humans
Female
Blood Pressure/physiology
Blood Pressure Determination
Hyperemia
Ischemia/diagnosis
Lower Extremity
blood pressure
hyperemia
leg cuff

Access to Document

10.1109/EMBC40787.2023.10341156

Cite this

Butlin, M., Cox, J. R., Tan, I., Avolio, A. P., & Bentley, G. J. (2023). Bilateral cuff-induced lower limb post-ischemia hyperemia as a method for acute reduction in blood pressure for cuffless blood pressure device testing. In 2023 45th Annual International Conference of the IEEE Engineering in Medicine & Biology Conference (EMBC): Proceedings (Annual International Conference of the IEEE Engineering in Medicine and Biology Society). Institute of Electrical and Electronics Engineers (IEEE). https://doi.org/10.1109/EMBC40787.2023.10341156

Butlin, Mark ; Cox, James R. ; Tan, Isabella et al. / Bilateral cuff-induced lower limb post-ischemia hyperemia as a method for acute reduction in blood pressure for cuffless blood pressure device testing. 2023 45th Annual International Conference of the IEEE Engineering in Medicine & Biology Conference (EMBC): Proceedings. USA : Institute of Electrical and Electronics Engineers (IEEE), 2023. (Annual International Conference of the IEEE Engineering in Medicine and Biology Society).

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title = "Bilateral cuff-induced lower limb post-ischemia hyperemia as a method for acute reduction in blood pressure for cuffless blood pressure device testing",

abstract = "Objective: Development and testing of cuffless blood pressure (BP) devices requires methods to increase and decrease BP. This is also required by cuffless BP validation standards. Pharmacological interventions, whilst successful, are not always feasible for all subpopulations or research settings. Non-pharmacological approaches for increasing BP are available, however, methods for decreasing BP are not well described. This study investigates the hyperemic response following bilateral leg-cuff ischemia as a method for acute BP lowering.Design and Method: Participants (n=8, 24±8 years, 6 female) had their BP measured by continuous (finger, Pe{\v n}{\'a}z technique) and intermittent (brachial cuff, oscillometric) methods before, during and following 3-minute leg-ischemia with the participant in an upright position. Total peripheral resistance (TPR) and cardiac output (CO) were calculated from finger BP waveforms. Maxima and minima responses in the variables were extracted and compared to resting conditions by repeated measures analysis of covariance.Results: During the hyperemic period, systolic BP decreased by -22±3 mmHg (finger) and -6±1 mmHg (brachial). Diastolic BP decreased by -14±5 mmHg (finger) and -4 ±1 mmHg (brachial). Calculated TPR and CO varied, with both decreasing by half and almost doubling during the hyperemic response period.Conclusions: Leg-cuff ischemia provides a controlled, non-pharmacological intervention for decreasing systemic arterial BP. This removes some of the limitations in testing, development and validation of cuffless BP techniques and devices.",

keywords = "Humans, Female, Blood Pressure/physiology, Blood Pressure Determination, Hyperemia, Ischemia/diagnosis, Lower Extremity, blood pressure, hyperemia, leg cuff",

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booktitle = "2023 45th Annual International Conference of the IEEE Engineering in Medicine & Biology Conference (EMBC)",

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Butlin, M , Cox, JR , Tan, I , Avolio, AP & Bentley, GJ 2023, Bilateral cuff-induced lower limb post-ischemia hyperemia as a method for acute reduction in blood pressure for cuffless blood pressure device testing. in 2023 45th Annual International Conference of the IEEE Engineering in Medicine & Biology Conference (EMBC): Proceedings. Annual International Conference of the IEEE Engineering in Medicine and Biology Society, Institute of Electrical and Electronics Engineers (IEEE), USA, Annual International Conference of the IEEE Engineering in Medicine and Biology Conference (45th : 2023), Sydney, New South Wales, Australia, 24/07/23. https://doi.org/10.1109/EMBC40787.2023.10341156

Bilateral cuff-induced lower limb post-ischemia hyperemia as a method for acute reduction in blood pressure for cuffless blood pressure device testing. / Butlin, Mark ; Cox, James R.; Tan, Isabella et al.
2023 45th Annual International Conference of the IEEE Engineering in Medicine & Biology Conference (EMBC): Proceedings. USA: Institute of Electrical and Electronics Engineers (IEEE), 2023. (Annual International Conference of the IEEE Engineering in Medicine and Biology Society).

Research output: Chapter in Book/Report/Conference proceeding › Conference proceeding contribution › peer-review

TY - GEN

T1 - Bilateral cuff-induced lower limb post-ischemia hyperemia as a method for acute reduction in blood pressure for cuffless blood pressure device testing

AU - Butlin, Mark

AU - Cox, James R.

AU - Tan, Isabella

AU - Avolio, Alberto P.

AU - Bentley, Gisele J.

PY - 2023/7/1

Y1 - 2023/7/1

N2 - Objective: Development and testing of cuffless blood pressure (BP) devices requires methods to increase and decrease BP. This is also required by cuffless BP validation standards. Pharmacological interventions, whilst successful, are not always feasible for all subpopulations or research settings. Non-pharmacological approaches for increasing BP are available, however, methods for decreasing BP are not well described. This study investigates the hyperemic response following bilateral leg-cuff ischemia as a method for acute BP lowering.Design and Method: Participants (n=8, 24±8 years, 6 female) had their BP measured by continuous (finger, Peňáz technique) and intermittent (brachial cuff, oscillometric) methods before, during and following 3-minute leg-ischemia with the participant in an upright position. Total peripheral resistance (TPR) and cardiac output (CO) were calculated from finger BP waveforms. Maxima and minima responses in the variables were extracted and compared to resting conditions by repeated measures analysis of covariance.Results: During the hyperemic period, systolic BP decreased by -22±3 mmHg (finger) and -6±1 mmHg (brachial). Diastolic BP decreased by -14±5 mmHg (finger) and -4 ±1 mmHg (brachial). Calculated TPR and CO varied, with both decreasing by half and almost doubling during the hyperemic response period.Conclusions: Leg-cuff ischemia provides a controlled, non-pharmacological intervention for decreasing systemic arterial BP. This removes some of the limitations in testing, development and validation of cuffless BP techniques and devices.

AB - Objective: Development and testing of cuffless blood pressure (BP) devices requires methods to increase and decrease BP. This is also required by cuffless BP validation standards. Pharmacological interventions, whilst successful, are not always feasible for all subpopulations or research settings. Non-pharmacological approaches for increasing BP are available, however, methods for decreasing BP are not well described. This study investigates the hyperemic response following bilateral leg-cuff ischemia as a method for acute BP lowering.Design and Method: Participants (n=8, 24±8 years, 6 female) had their BP measured by continuous (finger, Peňáz technique) and intermittent (brachial cuff, oscillometric) methods before, during and following 3-minute leg-ischemia with the participant in an upright position. Total peripheral resistance (TPR) and cardiac output (CO) were calculated from finger BP waveforms. Maxima and minima responses in the variables were extracted and compared to resting conditions by repeated measures analysis of covariance.Results: During the hyperemic period, systolic BP decreased by -22±3 mmHg (finger) and -6±1 mmHg (brachial). Diastolic BP decreased by -14±5 mmHg (finger) and -4 ±1 mmHg (brachial). Calculated TPR and CO varied, with both decreasing by half and almost doubling during the hyperemic response period.Conclusions: Leg-cuff ischemia provides a controlled, non-pharmacological intervention for decreasing systemic arterial BP. This removes some of the limitations in testing, development and validation of cuffless BP techniques and devices.

KW - Humans

KW - Female

KW - Blood Pressure/physiology

KW - Blood Pressure Determination

KW - Hyperemia

KW - Ischemia/diagnosis

KW - Lower Extremity

KW - blood pressure

KW - hyperemia

KW - leg cuff

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U2 - 10.1109/EMBC40787.2023.10341156

DO - 10.1109/EMBC40787.2023.10341156

M3 - Conference proceeding contribution

C2 - 38083571

SN - 9798350324488

T3 - Annual International Conference of the IEEE Engineering in Medicine and Biology Society

BT - 2023 45th Annual International Conference of the IEEE Engineering in Medicine & Biology Conference (EMBC)

PB - Institute of Electrical and Electronics Engineers (IEEE)

CY - USA

T2 - Annual International Conference of the IEEE Engineering in Medicine and Biology Conference (45th : 2023)

Y2 - 24 July 2023 through 27 July 2023

ER -

Butlin M , Cox JR , Tan I , Avolio AP, Bentley GJ. Bilateral cuff-induced lower limb post-ischemia hyperemia as a method for acute reduction in blood pressure for cuffless blood pressure device testing. In 2023 45th Annual International Conference of the IEEE Engineering in Medicine & Biology Conference (EMBC): Proceedings. USA: Institute of Electrical and Electronics Engineers (IEEE). 2023. (Annual International Conference of the IEEE Engineering in Medicine and Biology Society). doi: 10.1109/EMBC40787.2023.10341156

Bilateral cuff-induced lower limb post-ischemia hyperemia as a method for acute reduction in blood pressure for cuffless blood pressure device testing

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