Cuffless estimation of blood pressure: importance of variability in blood pressure dependence of arterial stiffness across individuals and measurement sites

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Objective: Measuring arterial pulse transit time (PTT) to estimate blood pressure (BP) without conventional brachial cuff-based measurement is not new, but is a focus of current wearable technologies research. Much research pertains to efficient, accurate sensing of artery-related waveforms, yet the relationship between PTT and BP receives less attention despite being key for accurate BP estimation. This study investigated BP/PTT calibration by quantifying anatomical site variability (n=10, 3 female, age 30±9 years) and individual variability (n=103, 50 female, age 53±22 years). Methods: BP and pulse wave velocity (PWV) were measured both seated and supine. Carotid-femoral PWV (cfPWV), carotid-radial PWV (crPWV) and carotid-finger-volume PWV (cvPWV) were measured with the wrist and hand positioned at the level of the upper thigh to achieve the same hydrostatic pressure effect across all measurements. Results: The postural change invoked a small (4±7 mmHg) change in brachial diastolic BP with an additional 27±2 mmHg change in hydrostatic pressure. cfPWV decreased in the supine position (-1.75±0.17 m•s-1, p<0.001) but crPWV and cvPWV were more variable. The calibration term (ΔBP/ΔPWV) across the sample population varied from 6.6 to 98.3 mmHg•s•m-1 (mean 22±14 mmHg•s•m-1) and was correlated with age, heart rate, diastolic and pulse pressure, and weight. These variables did not explain the majority of the variability (R2=0.248). Conclusion: There is anatomical site and between-individual variability in the calibration term for BP estimation from PTT. Significance: Using and accurately calculating hydrostatic changes in BP within the individual may be one method to increase accuracy of this calibration term.

LanguageEnglish
Pages2377-2383
Number of pages7
JournalIEEE Transactions on Biomedical Engineering
Volume65
Issue number11
Early online date5 Apr 2018
DOIs
Publication statusPublished - Nov 2018

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Blood pressure
Stiffness
Calibration
Hydrostatic pressure
Pressure effects

Keywords

  • Arteries
  • biological techniques
  • biomedical equipment
  • Biomedical measurement
  • Brachytherapy
  • Calibration
  • cuffless blood pressure
  • Position measurement
  • Pressure measurement
  • pulse transit time
  • pulse wave velocity
  • Time measurement

Cite this

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title = "Cuffless estimation of blood pressure: importance of variability in blood pressure dependence of arterial stiffness across individuals and measurement sites",
abstract = "Objective: Measuring arterial pulse transit time (PTT) to estimate blood pressure (BP) without conventional brachial cuff-based measurement is not new, but is a focus of current wearable technologies research. Much research pertains to efficient, accurate sensing of artery-related waveforms, yet the relationship between PTT and BP receives less attention despite being key for accurate BP estimation. This study investigated BP/PTT calibration by quantifying anatomical site variability (n=10, 3 female, age 30±9 years) and individual variability (n=103, 50 female, age 53±22 years). Methods: BP and pulse wave velocity (PWV) were measured both seated and supine. Carotid-femoral PWV (cfPWV), carotid-radial PWV (crPWV) and carotid-finger-volume PWV (cvPWV) were measured with the wrist and hand positioned at the level of the upper thigh to achieve the same hydrostatic pressure effect across all measurements. Results: The postural change invoked a small (4±7 mmHg) change in brachial diastolic BP with an additional 27±2 mmHg change in hydrostatic pressure. cfPWV decreased in the supine position (-1.75±0.17 m•s-1, p<0.001) but crPWV and cvPWV were more variable. The calibration term (ΔBP/ΔPWV) across the sample population varied from 6.6 to 98.3 mmHg•s•m-1 (mean 22±14 mmHg•s•m-1) and was correlated with age, heart rate, diastolic and pulse pressure, and weight. These variables did not explain the majority of the variability (R2=0.248). Conclusion: There is anatomical site and between-individual variability in the calibration term for BP estimation from PTT. Significance: Using and accurately calculating hydrostatic changes in BP within the individual may be one method to increase accuracy of this calibration term.",
keywords = "Arteries, biological techniques, biomedical equipment, Biomedical measurement, Brachytherapy, Calibration, cuffless blood pressure, Position measurement, Pressure measurement, pulse transit time, pulse wave velocity, Time measurement",
author = "Mark Butlin and Fatemeh Shirbani and Edward Barin and Isabella Tan and Bart Spronck and Alberto Avolio",
year = "2018",
month = "11",
doi = "10.1109/TBME.2018.2823333",
language = "English",
volume = "65",
pages = "2377--2383",
journal = "IEEE Transactions on Biomedical Engineering",
issn = "0018-9294",
publisher = "Institute of Electrical and Electronics Engineers (IEEE)",
number = "11",

}

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T1 - Cuffless estimation of blood pressure

T2 - IEEE Transactions on Biomedical Engineering

AU - Butlin, Mark

AU - Shirbani, Fatemeh

AU - Barin, Edward

AU - Tan, Isabella

AU - Spronck, Bart

AU - Avolio, Alberto

PY - 2018/11

Y1 - 2018/11

N2 - Objective: Measuring arterial pulse transit time (PTT) to estimate blood pressure (BP) without conventional brachial cuff-based measurement is not new, but is a focus of current wearable technologies research. Much research pertains to efficient, accurate sensing of artery-related waveforms, yet the relationship between PTT and BP receives less attention despite being key for accurate BP estimation. This study investigated BP/PTT calibration by quantifying anatomical site variability (n=10, 3 female, age 30±9 years) and individual variability (n=103, 50 female, age 53±22 years). Methods: BP and pulse wave velocity (PWV) were measured both seated and supine. Carotid-femoral PWV (cfPWV), carotid-radial PWV (crPWV) and carotid-finger-volume PWV (cvPWV) were measured with the wrist and hand positioned at the level of the upper thigh to achieve the same hydrostatic pressure effect across all measurements. Results: The postural change invoked a small (4±7 mmHg) change in brachial diastolic BP with an additional 27±2 mmHg change in hydrostatic pressure. cfPWV decreased in the supine position (-1.75±0.17 m•s-1, p<0.001) but crPWV and cvPWV were more variable. The calibration term (ΔBP/ΔPWV) across the sample population varied from 6.6 to 98.3 mmHg•s•m-1 (mean 22±14 mmHg•s•m-1) and was correlated with age, heart rate, diastolic and pulse pressure, and weight. These variables did not explain the majority of the variability (R2=0.248). Conclusion: There is anatomical site and between-individual variability in the calibration term for BP estimation from PTT. Significance: Using and accurately calculating hydrostatic changes in BP within the individual may be one method to increase accuracy of this calibration term.

AB - Objective: Measuring arterial pulse transit time (PTT) to estimate blood pressure (BP) without conventional brachial cuff-based measurement is not new, but is a focus of current wearable technologies research. Much research pertains to efficient, accurate sensing of artery-related waveforms, yet the relationship between PTT and BP receives less attention despite being key for accurate BP estimation. This study investigated BP/PTT calibration by quantifying anatomical site variability (n=10, 3 female, age 30±9 years) and individual variability (n=103, 50 female, age 53±22 years). Methods: BP and pulse wave velocity (PWV) were measured both seated and supine. Carotid-femoral PWV (cfPWV), carotid-radial PWV (crPWV) and carotid-finger-volume PWV (cvPWV) were measured with the wrist and hand positioned at the level of the upper thigh to achieve the same hydrostatic pressure effect across all measurements. Results: The postural change invoked a small (4±7 mmHg) change in brachial diastolic BP with an additional 27±2 mmHg change in hydrostatic pressure. cfPWV decreased in the supine position (-1.75±0.17 m•s-1, p<0.001) but crPWV and cvPWV were more variable. The calibration term (ΔBP/ΔPWV) across the sample population varied from 6.6 to 98.3 mmHg•s•m-1 (mean 22±14 mmHg•s•m-1) and was correlated with age, heart rate, diastolic and pulse pressure, and weight. These variables did not explain the majority of the variability (R2=0.248). Conclusion: There is anatomical site and between-individual variability in the calibration term for BP estimation from PTT. Significance: Using and accurately calculating hydrostatic changes in BP within the individual may be one method to increase accuracy of this calibration term.

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KW - biological techniques

KW - biomedical equipment

KW - Biomedical measurement

KW - Brachytherapy

KW - Calibration

KW - cuffless blood pressure

KW - Position measurement

KW - Pressure measurement

KW - pulse transit time

KW - pulse wave velocity

KW - Time measurement

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DO - 10.1109/TBME.2018.2823333

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JF - IEEE Transactions on Biomedical Engineering

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