Advances in blood pressure monitoring illuminate path forward for more comfortable devices

The continued rise of cardiovascular disease has placed new demands on comfortable, less disruptive continuous non-invasive blood pressure monitoring. An alternative to traditional inflatable blood pressure cuffs, called photoplethysmography (PPG), uses light scattering to make such measurements but is hampered by poor precision and long-term stability as well as frequent calibration requirements, lack of portability, and suboptimal comfort.

Chen et al. took stock of recent advances in PPG-based blood pressure monitoring technology and provided a roadmap for how such technology can be honed for future use. They addressed evaluation methods for assessing PPG signal quality and the cuff-free blood pressure estimation technology based on PPG signals and analyzed the influence of individual differences.

“According to a 2023 report by the World Health Organization, less than half of the more than 1 billion adults with high blood pressure are being diagnosed and treated properly,” said author Gang Chen. “Better continuous, real-time, precise, and stable blood pressure monitoring can give doctors profound insights into patients’ blood pressure fluctuations and potential risks, thereby enabling the development of more personalized treatment strategies.”

Long-term accuracy of non-invasive blood pressure devices is known to deteriorate over time, requiring frequent calibration with traditional cuffs and sometimes ECG electrodes. Multi-sensor devices and machine learning models show promise for maintaining accuracy with minimal input from ECGs, cuffs, and other devices.

With improvements, PPG devices could help to understand how blood pressures change during sleep, a particularly difficult task as most blood pressure monitoring risks stirring patients awake.

Chen hopes to inspire others to continue integrating the technology into the myriad devices and software already used in healthcare while increasing acceptance from clinicians.

Source: “A review: Blood pressure monitoring based on PPG and circadian rhythm,” by Gang Chen, Linglin Zou, and Zhong Ji, APL Bioengineering (2024). The article can be accessed at https://doi.org/10.1063/5.0206980 .