Cuffless Single-Site Photoplethysmography for Blood Pressure Monitoring

Manish Hosanee¹, Gabriel Chan¹, Kaylie Welykholowa¹, Rachel Cooper¹, Panayiotis A Kyriacou², Dingchang Zheng³, John Allen⁴, Derek Abbott^{5

6}, Carlo Menon⁷, Nigel H Lovell⁸, Newton Howard⁹, Wee-Shian Chan¹, Kenneth Lim¹, Richard Fletcher^{10

11}, Rabab Ward¹², Mohamed Elgendi^{1

7

12

13}

Affiliations

¹ Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
² Research Centre for Biomedical Engineering, City, University of London, London EC1V 0HB, UK.
³ Research Center of Intelligent Healthcare, Faculty of Health and Life Science, Coventry University, Coventry CV1 5FB, UK.
⁴ Northern Medical Physics and Clinical Engineering, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK.
⁵ School of Electrical and Electronic Engineering, The University of Adelaide, Adelaide, SA 5005, Australia.
⁶ Centre for Biomedical Engineering, The University of Adelaide, Adelaide, SA 5005, Australia.
⁷ School of Mechatronic Systems Engineering, Simon Fraser University, Burnaby, BC V5A 1S6, Canada.
⁸ Graduate School of Biomedical Engineering, UNSW Sydney, Sydney, NSW 2052, Australia.
⁹ Nuffield Department of Surgical Sciences, University of Oxford, Oxford OX3 9DU, UK.
¹⁰ D-Lab, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
¹¹ Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA 01655, USA.
¹² School of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
¹³ BC Children's & Women's Hospital, Vancouver, BC V6H 3N1, Canada.

PMID: 32155976
PMCID: PMC7141397
DOI: 10.3390/jcm9030723

Review

Cuffless Single-Site Photoplethysmography for Blood Pressure Monitoring

Manish Hosanee et al. J Clin Med. 2020.

. 2020 Mar 7;9(3):723.

doi: 10.3390/jcm9030723.

Authors

Affiliations

¹ Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z3, Canada.
² Research Centre for Biomedical Engineering, City, University of London, London EC1V 0HB, UK.
³ Research Center of Intelligent Healthcare, Faculty of Health and Life Science, Coventry University, Coventry CV1 5FB, UK.
⁴ Northern Medical Physics and Clinical Engineering, Freeman Hospital, Newcastle upon Tyne NE7 7DN, UK.
⁵ School of Electrical and Electronic Engineering, The University of Adelaide, Adelaide, SA 5005, Australia.
⁶ Centre for Biomedical Engineering, The University of Adelaide, Adelaide, SA 5005, Australia.
⁷ School of Mechatronic Systems Engineering, Simon Fraser University, Burnaby, BC V5A 1S6, Canada.
⁸ Graduate School of Biomedical Engineering, UNSW Sydney, Sydney, NSW 2052, Australia.
⁹ Nuffield Department of Surgical Sciences, University of Oxford, Oxford OX3 9DU, UK.
¹⁰ D-Lab, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.
¹¹ Department of Psychiatry, University of Massachusetts Medical School, Worcester, MA 01655, USA.
¹² School of Electrical and Computer Engineering, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
¹³ BC Children's & Women's Hospital, Vancouver, BC V6H 3N1, Canada.

PMID: 32155976
PMCID: PMC7141397
DOI: 10.3390/jcm9030723

Abstract

One in three adults worldwide has hypertension, which is associated with significant morbidity and mortality. Consequently, there is a global demand for continuous and non-invasive blood pressure (BP) measurements that are convenient, easy to use, and more accurate than the currently available methods for detecting hypertension. This could easily be achieved through the integration of single-site photoplethysmography (PPG) readings into wearable devices, although improved reliability and an understanding of BP estimation accuracy are essential. This review paper focuses on understanding the features of PPG associated with BP and examines the development of this technology over the 2010-2019 period in terms of validation, sample size, diversity of subjects, and datasets used. Challenges and opportunities to move single-site PPG forward are also discussed.

Keywords: PPG signal; biomedical engineering; biomedical signal analysis; blood pressure measurement; digital health; digital medicine; hypertension assessment; hypertension diagnosis; photoplethysmogram; photoplethysmography; pulse oximetry; wearable devices; wearable technology.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

**Figure 1**
Photoplethysmogram features and measurement sites of single-source photoplethysmography (PPG) in studies conducted between January 2010 and January 2019.

**Figure 2**
Flow diagram of the exclusion criteria used in this study. From the initial search total (n = 5217), 5192 studies were excluded, and 25 studies were identified.

**Figure 3**
Overall trend of publications that utilized single-measurement PPG to estimate BP from January 2010 to January 2019.

**Figure 4**
Pie chart of the hemodynamic status of participants in single-measurement PPG studies from January 2010 to January 2019.

**Figure 5**
Top 5 countries contributing single-site measurement PPG studies between January 2010 and January 2019. We recommend collaboration between research groups in these countries to identify an optimal approach to BP measurement using single-measurement PPG.

**Figure 6**
Pie chart of the percentage of studies published between January 2010 and January 2019 that used an automated BP (ABP) cuff, manual BP cuff, or invasive approach as a gold standard. Studies that did not disclose their gold standard method were classified as “not reported” (N/R). Usage of the ABP cuff as the gold standard could be used to assess the validity of PPG in estimating BP from an outpatient setting, while the use of intra-arterial catheters could be used to assess the validity of PPG in an inpatient hospitalized setting (e.g., in critical care units).

See this image and copyright information in PMC

References

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Cuffless Single-Site Photoplethysmography for Blood Pressure Monitoring

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Cuffless Single-Site Photoplethysmography for Blood Pressure Monitoring

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