Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Feasibility and Effectiveness of a Ring-Type Blood Pressure Measurement Device Compared With 24-Hour Ambulatory Blood Pressure Monitoring Device

  • Huijin Lee (Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital) ;
  • Sungjoon Park (Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital) ;
  • Hyuktae Kwon (Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Belong Cho (Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Jin Ho Park (Department of Family Medicine, Seoul National University Hospital, Seoul National University College of Medicine) ;
  • Hae-Young Lee (Division of Cardiology, Department of Internal Medicine, Seoul National University Hospital)
  • Received : 2023.11.15
  • Accepted : 2023.12.12
  • Published : 2024.02.01
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Abstract

Backgrounds and Objectives: This study aimed to evaluate the applicability and precision of a ring-type cuffless blood pressure (BP) measurement device, CART-I Plus, compared to conventional 24-hour ambulatory BP monitoring (ABPM). Methods: Forty patients were recruited, and 33 participants were included in the final analysis. Each participant wore both CART-I Plus and ABPM devices on the same arm for approximately 24 hours. BP estimation from CART-I Plus, derived from photoplethysmography (PPG) signals, were compared with the corresponding ABPM measurements. Results: The CART-I Plus recorded systolic blood pressure (SBP)/diastolic blood pressure (DBP) values of 131.4±14.1/81.1±12.0, 132.7±13.9/81.9±11.9, and 128.7±14.6/79.3±12.2 mmHg for 24-hour, daytime, and nighttime periods respectively, compared to ABPM values of 129.7±11.7/84.4±11.2, 131.9±11.6/86.3±11.1, and 124.5±13.6/80.0±12.2 mmHg. Mean differences in SBP/DBP between the two devices were 1.74±6.69/-3.24±6.51 mmHg, 0.75±7.44/-4.41±7.42 mmHg, and 4.15±6.15/-0.67±5.23 mmHg for 24-hour, daytime, and nighttime periods respectively. Strong correlations were also observed between the devices, with r=0.725 and r=0.750 for transitions in SBP and DBP from daytime to nighttime, respectively (both p<0.001). Conclusions: The CART-I Plus device, with its unique ring-type design, shows promising accuracy in BP estimation and offers a potential avenue for continuous BP monitoring in clinical practice.

Keywords

Acknowledgement

This work was sponsored by Sky Labs Inc.

References

  1. Fuchs FD, Whelton PK. High blood pressure and cardiovascular disease. Hypertension 2020;75:285-92.
  2. Ibrahim B, Jafari R. Cuffless blood pressure monitoring from a wristband with calibration-free algorithms for sensing location based on bio-impedance sensor array and autoencoder. Sci Rep 2022;12:319.
  3. Kario K, Shimada K, Pickering TG. Abnormal nocturnal blood pressure falls in elderly hypertension: clinical significance and determinants. J Cardiovasc Pharmacol 2003;41 Suppl 1:S61-6.
  4. Kario K, Shimada K. Risers and extreme-dippers of nocturnal blood pressure in hypertension: antihypertensive strategy for nocturnal blood pressure. Clin Exp Hypertens 2004;26:177-89.
  5. Kario K, Pickering TG, Matsuo T, Hoshide S, Schwartz JE, Shimada K. Stroke prognosis and abnormal nocturnal blood pressure falls in older hypertensives. Hypertension 2001;38:852-7.
  6. Williams B, Mancia G, Spiering W, et al. 2018 ESC/ESH Guidelines for the management of arterial hypertension. Eur Heart J 2018;39:3021-104.
  7. Whelton PK, Carey RM, Aronow WS, 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. Hypertension 2018;71:e13-115.
  8. Sherwood A, Hill LK, Blumenthal JA, Hinderliter AL. The effects of ambulatory blood pressure monitoring on sleep quality in men and women with hypertension: dipper vs. nondipper and race differences. Am J Hypertens 2019;32:54-60.
  9. Agarwal R, Light RP. The effect of measuring ambulatory blood pressure on nighttime sleep and daytime activity--implications for dipping. Clin J Am Soc Nephrol 2010;5:281-5.
  10. Davies RJ, Jenkins NE, Stradling JR. Effect of measuring ambulatory blood pressure on sleep and on blood pressure during sleep. BMJ 1994;308:820-3.
  11. Stergiou GS, Palatini P, Parati G, et al. 2021 European Society of Hypertension practice guidelines for office and out-of-office blood pressure measurement. J Hypertens 2021;39:1293-302.
  12. Teng X, Zhang YT. Proceedings of the 25th Annual International Conference of the IEEE Engineering in Medicine and Biology Society (IEEE Cat. No.03CH37439). Piscataway (NJ): Institute of Electrical and Electronics Engineers; 2003. p.3153-6.
  13. Elgendi M, Fletcher R, Liang Y, et al. The use of photoplethysmography for assessing hypertension. NPJ Digit Med 2019;2:60.
  14. Stergiou GS, Mukkamala R, Avolio A, et al. Cuffless blood pressure measuring devices: review and statement by the European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability. J Hypertens 2022;40:1449-60.
  15. El-Hajj C, Kyriacou PA. A review of machine learning techniques in photoplethysmography for the noninvasive cuff-less measurement of blood pressure. Biomed Signal Process Control 2020;58:101870.
  16. Stergiou GS, Avolio AP, Palatini P, et al. European Society of Hypertension recommendations for the validation of cuffless blood pressure measuring devices: European Society of Hypertension Working Group on Blood Pressure Monitoring and Cardiovascular Variability. J Hypertens 2023;41:2074-87.
  17. Joung J, Jung CW, Lee HC, et al. Continuous cuffless blood pressure monitoring using photoplethysmography-based PPG2BP-net for high intrasubject blood pressure variations. Sci Rep 2023;13:8605.
  18. Charmoy A, Wurzner G, Ruffieux C, et al. Reactive rise in blood pressure upon cuff inflation: cuff inflation at the arm causes a greater rise in pressure than at the wrist in hypertensive patients. Blood Press Monit 2007;12:275-80.
  19. International Organization for Standardization (ISO). ISO 81060-2:2018 Non-invasive sphygmomanometers-Part 2: Clinical investigation of intermittent automated measurement type. Geneva: International Organization for Standardization; 2018.
  20. Islam SM, Cartledge S, Karmakar C, et al. Validation and acceptability of a cuffless wrist-worn wearable blood pressure monitoring device among users and health care professionals: mixed methods study. JMIR Mhealth Uhealth 2019;7:e14706.
  21. Nachman D, Gilan A, Goldstein N, et al. Twenty-four-hour ambulatory blood pressure measurement using a novel noninvasive, cuffless, wireless device. Am J Hypertens 2021;34:1171-80.
  22. Falter M, Scherrenberg M, Driesen K, et al. Smartwatch-based blood pressure measurement demonstrates insufficient accuracy. Front Cardiovasc Med 2022;9:958212.
  23. Sola J, Cortes M, Perruchoud D, et al. Guidance for the interpretation of continual cuffless blood pressure data for the diagnosis and management of hypertension. Front Med Technol 2022;4:899143.
  24. Tan I, Gnanenthiran SR, Chan J, et al. Evaluation of the ability of a commercially available cuffless wearable device to track blood pressure changes. J Hypertens 2023;41:1003-10.
  25. Park SW. Prospective, Single-center, Single group, Pivotal clinical trial to evaluate the blood pressure accuracy of 'CART-I plus' compared to the reference blood pressure reading with an auscultatory sphygmomanometer. J Korean Med Sci. 2024 [Epub ahead of print].
  26. Nwankwo T, Coleman King SM, Ostchega Y, et al. Comparison of 3 devices for 24-hour ambulatory blood pressure monitoring in a nonclinical environment through a randomized trial. Am J Hypertens 2020;33:1021-9.