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

描述(申请人提供)：超过4000万美国人患有高血压。动脉高压(AP)的及时诊断和控制对于预防危及生命的并发症和终末器官损伤至关重要，但由于缺乏24小时(包括必要的夜间)AP追踪的无中断监测而受到阻碍。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：我们已经开发了一个技术平台，用于在智能手机和互联网服务器上对心电、体力活动、症状和依从性进行个性化、多参数监测，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验可行性数据，我们开发并测试了：1)基于智能手机的小型化AP波非侵入性跟踪系统的工作原型，以及2)具有个性化校准的稳健计算算法，用于根据AP波的速度和能量特征跟踪收缩压和舒张压的动态变化。该系统在人类受试者身上的试点测试产生了令人振奋的结果，并相当准确地跟踪了AP的趋势。我们还表明，外周血管活动是外周血管系统中AP和AP波之间关系的主要混杂因素。为了避免这种混杂的影响，我们将研究使用三种传感器探头跟踪中央动脉AP波的可行性，并确定在存在最常见的运动伪影和身体位置变化的情况下提供稳定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测试最常见的混杂因素、体重指数和躯干/乳房解剖中的性别差异，以进行一系列运动和身体位置变化。该系统的第一个应用是在家里进行夜间AP跟踪。

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.