A Personal, Nonobtrusive System for Tracking Arterial Blood Pressure at Home

描述（由申请人提供）：超过4000万美国人患有高血压。及时诊断和控制高动脉血压（AP）对于预防危及生命的并发症和终末器官损害至关重要，但由于缺乏24小时（包括必要的夜间）AP跟踪的非破坏性监测仪而受到阻碍。由于AP异常的流行比例，一个不显眼的、无袖带的AP监测仪将对数百万美国人的生活产生重大而持久的影响，特别是那些有心血管危险因素和慢性心血管疾病的人。背景：我们开发了一个技术平台，可以在智能手机和互联网服务器上进行个性化、多参数的心电图、身体活动、症状和依从性监测，并进行实时、双向、无线传输和基于模式识别的分析。最近，为了获得该项目的试点可行性数据，我们开发并测试了：1)一个基于智能手机的小型化无创AP波跟踪系统的工作原型；2)一个具有个性化校准的鲁棒计算算法，用于从AP波速度和能量特征跟踪收缩压和舒张压的动态。该系统在人类受试者中的试点测试产生了有希望的结果，并对AP趋势进行了相当准确的跟踪。我们还发现外周血管活动是影响外周血管AP和AP波之间关系的主要因素。为了消除这种混淆效应，我们将研究使用3种类型的传感器探头跟踪中央动脉AP波的可行性，并确定在最常见的运动伪影和身体位置变化源存在下提供稳定AP波信号的最佳传感器类型。在目标2中，原型系统将在健康受试者中进行测试，涉及最常见的混杂因素，身体质量指数和躯干/乳房解剖结构的性别差异，以进行一系列运动和身体姿势的变化。该系统的第一个应用是夜间在家跟踪AP。

DESCRIPTION (provided by applicant): Over 40 million Americans suffer from hypertension. Timely diagnosis and control of high arterial blood pressure (AP) are crucial for preventing life-threatening complications and end-organ damage but have been hampered by the lack of nondisruptive monitors for 24-hour (including essential nighttime) AP tracking. Due to the epidemic proportions of AP abnormalities, an unobtrusive, cuff-free AP monitor will have a significant, lasting impact on the lives of millions of Americans, particularly those with cardiovascular risk factors and chronic cardiovascular diseases. Background: We have developed a technological platform for personalized, multiparametric monitoring of electrocardiogram, physical activity, symptoms and compliance with real-time, two-way, wireless transmission and pattern-recognition-based analysis on a smart phone and on an Internet server. Recently, to obtain pilot feasibility data for this project, we developed and tested: 1) a working prototype of a miniaturized, smart- phone-based system for noninvasive tracking of AP wave, and 2) a robust computational algorithm with personalized calibration for tracking the dynamics of systolic and diastolic pressure from characteristics of AP- wave velocity and energy. Pilot testing of this system in human subjects yielded promising results and reasonably accurate tracking of AP trends. We have also shown that peripheral vascular activity is the main confounder of the relationship between AP and AP wave in the peripheral vasculature. To obviate this confounding effect, we will examine feasibility of tracking AP waves in the central arteries using 3 types of sensor probes and identify optimal sensor type that provides stable AP-wave signal in the presence of the most common sources of motion artifacts and changes in body position. In Aim 2, the prototype system will be tested in healthy subjects with respect to the most common confounders, BMI and gender differences in torso/breast anatomy for a range of movements and changes in body position. The first application of the system is for nighttime AP tracking at home.