Ballistocardiogram-Based Approach to Cuffless Blood Pressure Monitoring: Proof of Concept and Potential Challenges

<italic>Objective:</italic> The goal was to propose and establish the proof of concept of an ultraconvenient cuffless blood pressure monitoring approach based on the ballistocardiogram. <italic>Methods:</italic> The proposed approach monitors blood pressure by exploiting two features in the whole-body head-to-foot ballistocardiogram measured using a force plate: the time interval between the first (“I”) and second (“J”) major waves (“I–J interval”) for diastolic pressure and the amplitude between the J and third major (“K”) waves (“J–K amplitude”) for pulse pressure. The efficacy of the approach was examined in 22 young healthy volunteers by investigating the diastolic pressure monitoring performance of pulse transit time, pulse arrival time, and ballistocardiogram's I–J interval, and the systolic pressure monitoring performance of pulse transit time and I–J interval in conjunction with ballistocardiogram's J–K amplitude. <italic>Results:</italic> The I–J interval was comparable to pulse transit time and pulse arrival time in monitoring diastolic pressure, and the J–K amplitude could provide meaningful improvement to pulse transit time and I–J interval in monitoring systolic pressure. <italic>Conclusion:</italic> The ballistocardiogram may contribute toward ultraconvenient and more accurate cuffless blood pressure monitoring. <italic> Significance:</italic> The proposed approach has potential to complement the pulse transit time technique for cuffless blood pressure monitoring in two ways. First, it may be integrated with pulse transit time to enable independent monitoring of diastolic and systolic pressures via the J–K amplitude. Second, it may even enable diastolic and systolic pressure monitoring from the ballistocardiogram alone.