Cuff-less continuous measurement of blood pressure using wrist and fingertip photo-plethysmograms: Evaluation and feature analysis

Continuous monitoring of blood pressure improves prevention and control of cardiovascular diseases. Currently, cuff-based oscillometric sphygmomanometers are commonly used to monitor the systolic and diastolic blood pressure. However, this technique is discontinuous in nature and inconvenient for repeated measurements. Here we have proposed indirect measurement of blood pressure from photo-plethysmograms (PPG) simultaneously recorded from wrist and fingertip. The signals were recorded from 111 participants and different morphological features were obtained from PPG and its second derivative, acceleration plethysmograms (APG). Moreover, different measures of pulse transit time (PTT) and pulse wave velocity (PWV) were obtained from the recorded PPGs. Multi-layer Neural Networks were used to estimate the non-linear relationship between these features and systolic and diastolic blood pressures (SBP and DBP). Mean absolute errors of 6.77 and 4.82 mmHg were achieved in comparison with measurements from a validated commercial oscillometric sphygmomanometer. Feature analysis provided insight about the importance of features for estimating BP, and demonstrated that these features are not the same for SBP and DBP. Using the highest-ranked 15 and 13 features obtained from moving-backward algorithm the mean absolute errors were reduced to 5.31 and 4.62 mmHg for SBP and DBP. However, the optimum optimal feature sets provided by a genetic algorithm for estimating SBP/DBP led to the lowest mean absolute errors of 4.94/4.03. These results compared to previous studies and the available standards suggest that the method is a promising substitute for oscillometric sphygmomanometers which can be used conveniently for continuous monitoring of blood pressure. (C) 2018 Elsevier Ltd. All rights reserved.