An Unobtrusive Continuous Cuff-less Blood Pressure Monitor for Nocturnal Hypertension

项目摘要/摘要 该项目的目标是创造一种不显眼、戴手腕、无袖带的血压监测仪，用于测量和 夜间非潜伏期高血压的识别。调查包括用最先进的技术进行广泛的验证 在存在不同治疗模式的情况下，夜间动态血压监测。心血管病 心血管疾病(CVD)是世界范围内引起疾病的主要原因之一。仅高血压一项就会影响三分之一的成年人 给世界卫生组织。因此，监测血压已成为医疗保健的重要组成部分 已知与许多心血管疾病有关。传统上，临床医生依赖于水银(或数字) 等价物)充气袖套式血压计。然而，该设备的性质仅允许不频繁地 测量及其侵入性和相关的不适禁止额外的夜间测量。 在用户环境的自然环境中连续测量血压肯定是有价值的 特别是在睡眠时，不受仪器干扰。我们建议的技术可以提供丰富的 向医生提供信息，帮助识别某些短期动态/血压变化，并允许有效 监测对药物的反应等。夜间测量提供了额外的预后价值 在识别风险方面。尽管有这些好处，但没有可穿戴的、非侵入性的持续血压监测设备 市场上存在的原因很简单，因为没有一种足够可靠，可以被认为是临床级别的。该项目旨在 开发一种坚固可靠的血压监测器，其形式是使用生物阻抗传感器的手腕佩戴设备， 并首次证明了临床分级的可靠性。这些传感器测量脉搏波速度(PWV)以及 其他几种心血管参数的导数，包括心率和动脉血容量的变化，这些 与血压相关。该系统将结合智能硬件设计来定位潜在的血管系统 并将重点放在动脉部位以提高准确性。该设备将包括一个运动传感器，以考虑到用户的 运动和运动伪影、接触质量和测量的可靠性。高级机器学习 将开发利用通用模型和个性化模型的技术来转换生物阻抗测量 与血压有关。该项目的目标是随后在健康的患者队列和 高血压队列，了解夜间“非降压”高血压和降压治疗的影响 PWV/其他心血管相关因素和血压估计。在几十年来一直依赖充气袖口之后- 基于技术，这个系统可能代表着我们测量血压的方式的重大变化。

PROJECT SUMMARY/ABSTRACT The objective of this project is to create an unobtrusive, wrist-worn, cuff-less blood pressure monitor for measurement and identification of nocturnal nondipping hypertension. The investigation includes extensive validation with state-of-the-art ambulatory blood pressure monitors at nighttime in presence of heterogeneous treatment paradigms. Cardiovascular disease (CVD) is one of the major causes of ailments worldwide. Hypertension alone affects one in three adults according to the World Health Organization. Therefore, monitoring blood pressure has become a critical part of healthcare as it is known to be linked to many CVDs. Traditionally, clinical practitioners have relied on the mercury-based (or digital equivalent) inflatable cuff-based sphygmomanometer. However, the nature of the device allows for only infrequent measurements and its somewhat invasive nature and associated discomfort prohibits additional nocturnal measurements. There is certainly a value to measuring blood pressure continuously in the natural context of the user’s environment, in particular during sleep, without being disturbed by the instrument. Our proposed technology can provide a wealth of information to physicians, help identify certain short-term dynamics/variations of blood pressure, and allow effective monitoring of response to medication, among other things. Nocturnal measurements provide additional prognostic value in identifying risk. Despite these benefits, no wearable, non-invasive device for continuous blood pressure monitoring exists on the market simply because none have been reliable enough to be considered clinical grade. This project aims to develop a robust and reliable blood pressure monitor in the form of a wrist-worn device that uses bio-impedance sensors, and for the first time, demonstrate clinical grade reliability. These sensors measure pulse wave velocity (PWV) along with several other derivatives for cardiovascular parameters including heart rate and blood volume changes in arteries, which correlate with the blood pressure. The system will incorporate clever hardware design to localize underlying vasculature and focus on arterial sites for enhanced accuracy. The device will include a motion sensor to take into account the user’s movements and motion artifacts, the contact quality, and reliability of the measurements. Advanced machine learning techniques, leveraging both general and personalized models, will be developed to convert bio-impedance measurements to blood pressure. This project aims to then validate the system and analytics in both a healthy patient cohort and a hypertensive cohort, learning the impact that nocturnal ‘nondipping’ hypertension and anti-hypertensive treatments have on PWV/other cardiovascular correlates and blood pressure estimates. After decades of relying on the inflatable cuff- based technique, this system could represent a significant change in how we measure blood pressure.