Validation of a wearable cuff-less wristwatch-type blood pressure monitoring device

Ambulatory blood pressure (BP) monitoring is recommended to improve the management of hypertension. Here, we investigated the accuracy of BP estimated using a wearable cuff-less device, InBodyWATCH, compared with BP measured using a manual sphygmomanometer. Thirty-five adults were enrolled (age 57.1 ± 17.9 years). The BP was estimated using InBodyWATCH with an individualized estimation based on a neural network model. Three paired sets of BPs from the two devices were compared using correlation analysis and Bland–Altman plots (n = 105 paired BP readings). The correlations for both systolic and diastolic BP (SBP and DBP) between the two devices were high (r = 0.964 and 0.939, both P < 0.001). The mean difference was 2.2 ± 6.1 mmHg for SBP and −0.2 ± 4.2 mmHg for DBP; these were not significant (P = 0.472 for SBP and P = 0.880 for DBP). The proportions of estimated SBP/DBP obtained from the InBodyWATCH within ± 5 mmHg of manual SBP/DBP were 71.4%/83.8%; within ± 10 mmHg they were 86.7%/98.1%; and within ± 15 mmHg they were 97.1%/99.0%. The estimated BP from this wearable cuff-less device correlated highly with the manual BP and showed good accuracy, suggesting its potential to be used in ambulatory BP monitoring.

[1]  Peter W de Leeuw,et al.  Prognostic value of ambulatory blood-pressure recordings in patients with treated hypertension. , 2003, The New England journal of medicine.

[2]  J. Connell,et al.  Higher carotid‐radial pulse wave velocity in healthy offspring of patients with Type 2 diabetes , 2004, Diabetic medicine : a journal of the British Diabetic Association.

[3]  Roberto Sega,et al.  Prognostic Value of Ambulatory and Home Blood Pressures Compared With Office Blood Pressure in the General Population: Follow-Up Results From the Pressioni Arteriose Monitorate e Loro Associazioni (PAMELA) Study , 2005, Circulation.

[4]  Carmen C. Y. Poon,et al.  Cuff-less and Noninvasive Measurements of Arterial Blood Pressure by Pulse Transit Time , 2005, 2005 IEEE Engineering in Medicine and Biology 27th Annual Conference.

[5]  T. Togawa,et al.  Continuous estimation of systolic blood pressure using the pulse arrival time and intermittent calibration , 2000, Medical and Biological Engineering and Computing.

[6]  John D. Hunter,et al.  Matplotlib: A 2D Graphics Environment , 2007, Computing in Science & Engineering.

[7]  Yutaka Imai,et al.  European Society of Hypertension International Protocol revision 2010 for the validation of blood pressure measuring devices in adults , 2010, Blood pressure monitoring.

[8]  Jeffrey P Koplan,et al.  Global noncommunicable diseases--where worlds meet. , 2010, The New England journal of medicine.

[9]  S. Angell,et al.  Global health. Global indicators and targets for noncommunicable diseases. , 2012, Science.

[10]  S. Angell,et al.  Global Indicators and Targets for Noncommunicable Diseases , 2012, Science.

[11]  K. Kario,et al.  Prognostic impact from clinic, daytime, and night-time systolic blood pressure in nine cohorts of 13 844 patients with hypertension , 2014, Journal of hypertension.

[12]  Zhi-Hong Mao,et al.  Cuff-free blood pressure estimation using pulse transit time and heart rate , 2014, 2014 12th International Conference on Signal Processing (ICSP).

[13]  Wenli Wu,et al.  [Mobile Health: IEEE Standard for Wearable Cuffless Blood Pressure Measuring Devices]. , 2015, Zhongguo yi liao qi xie za zhi = Chinese journal of medical instrumentation.

[14]  A. Peixoto Practical Aspects of Home and Ambulatory Blood Pressure Monitoring. , 2015, Methodist DeBakey cardiovascular journal.

[15]  Sergey Ioffe,et al.  Batch Normalization: Accelerating Deep Network Training by Reducing Internal Covariate Shift , 2015, ICML.

[16]  H. Snieder,et al.  Pulse wave velocity in elastic and muscular arteries: tracking stability and association with anthropometric and hemodynamic measurements , 2016, Hypertension Research.

[17]  Roozbeh Jafari,et al.  BioWatch: A Noninvasive Wrist-Based Blood Pressure Monitor That Incorporates Training Techniques for Posture and Subject Variability , 2016, IEEE Journal of Biomedical and Health Informatics.

[18]  Laura A. Tuttle,et al.  Dollars and Discomfort: What Will People Be Willing to Give for Better Blood Pressure Assessment? , 2016, Journal of clinical hypertension.

[19]  Mingshan Sun,et al.  Optical blood pressure estimation with photoplethysmography and FFT-based neural networks. , 2016, Biomedical optics express.

[20]  Andrew M. Carek,et al.  SeismoWatch , 2017 .

[21]  Omer T. Inan,et al.  SeismoWatch , 2017, Proc. ACM Interact. Mob. Wearable Ubiquitous Technol..

[22]  Xuan Zeng,et al.  Highly wearable cuff-less blood pressure and heart rate monitoring with single-arm electrocardiogram and photoplethysmogram signals , 2017, BioMedical Engineering OnLine.

[23]  Joon-Hyuk Chang,et al.  Oscillometric Blood Pressure Estimation Based on Deep Learning , 2017, IEEE Transactions on Industrial Informatics.

[24]  Jackson T. Wright,et al.  2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. , 2018, Journal of the American Society of Hypertension : JASH.

[25]  Thomas Kahan,et al.  2018 ESC/ESH Guidelines for the management of arterial hypertension. , 2018, European heart journal.

[26]  Eyal Oren,et al.  The State of US Health, 1990-2016: Burden of Diseases, Injuries, and Risk Factors Among US States , 2018, JAMA.

[27]  J. Williamson,et al.  2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. , 2018, Hypertension.

[28]  Wilbert S Aronow,et al.  2017 ACC/AHA/AAPA/ABC/ACPM/AGS/APhA/ASH/ASPC/NMA/PCNA Guideline for the Prevention, Detection, Evaluation, and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines. , 2018, Hypertension.

[29]  Brett S. Nickerson,et al.  Reliability and Agreement of Various InBody Body Composition Analyzers as Compared to Dual-Energy X-Ray Absorptiometry in Healthy Men and Women. , 2020, Journal of clinical densitometry : the official journal of the International Society for Clinical Densitometry.

[30]  S. Islam,et al.  Validation and Acceptability of a Cuffless Wrist-Worn Wearable Blood Pressure Monitoring Device Among Users and Health Care Professionals: Mixed Methods Study , 2019, JMIR mHealth and uHealth.

[31]  Corrigendum to: 2018 ESC/ESH Guidelines for the management of arterial hypertension. , 2018, European heart journal.

[32]  Dong-Hwa Lee,et al.  Components of Metabolic Syndrome in Korean Adults: A Hospital-Based Cohort at Seoul National University Bundang Hospital , 2019, Journal of obesity & metabolic syndrome.

[33]  Bernadine Brady,et al.  A MIXED-METHODS STUDY , 2019 .

[34]  J. Schwartz,et al.  The first study comparing a wearable watch‐type blood pressure monitor with a conventional ambulatory blood pressure monitor on in‐office and out‐of‐office settings , 2020, Journal of clinical hypertension.

[35]  Daniel W. Jones,et al.  Hypertension (Blood Pressure) and Lifetime Risk of Target Organ Damage , 2020, Current Hypertension Reports.

[36]  E. Rhee,et al.  Effects of Cardiovascular Risk Factor Variability on Health Outcomes , 2020, Endocrinology and metabolism.

[37]  Joel Nothman,et al.  SciPy 1.0-Fundamental Algorithms for Scientific Computing in Python , 2019, ArXiv.