open access
Photoplethysmography technology use in smart devices for early diagnosis of arterial hypertension: a systematic review
Affiliations- Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
- Department of Family Medicine, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania
open access
Abstract
Background: According to the World Health Organisation (WHO), 1 in 4 men and 1 in 5 women have arterial hypertension (AH). It is important to diagnose AH early and constantly monitor blood pressure (BP). We assess the diagnostic accuracy of AH detection using smart devices with photoplethysmography (PPG) and seek to provide guidance from current evidence to clinicians about the value and limitations of their potential use to early diagnose this chronic disease.
Material and methods: This systematic review of Medline, Google Scholar, and PubMed databases was conducted according to the PRISMA guidelines. All publications examining any type of AH detection using PPG in smart devices were evaluated. Study quality was assessed using the QUADAS-2 risk of bias tool.
Results: The search strategy identified a total of 705 publications, of which 9 studies were included in the systematic review. Of the 9 studies included, 2 used Samsung Galaxy smartphones, and 7 used wearable watch-like devices. A sphygmomanometer was used as a reference standard in all studies.
Conclusion: The current evidence base consists of small, biased, and low-quality studies which are insufficient to advise clinicians on the true value of PPG devices for AH detection. Further research is required with reference standards, standardized validation, and transparent algorithms for PPG technology to be used as a valid tool for early AH diagnosis.
Abstract
Background: According to the World Health Organisation (WHO), 1 in 4 men and 1 in 5 women have arterial hypertension (AH). It is important to diagnose AH early and constantly monitor blood pressure (BP). We assess the diagnostic accuracy of AH detection using smart devices with photoplethysmography (PPG) and seek to provide guidance from current evidence to clinicians about the value and limitations of their potential use to early diagnose this chronic disease.
Material and methods: This systematic review of Medline, Google Scholar, and PubMed databases was conducted according to the PRISMA guidelines. All publications examining any type of AH detection using PPG in smart devices were evaluated. Study quality was assessed using the QUADAS-2 risk of bias tool.
Results: The search strategy identified a total of 705 publications, of which 9 studies were included in the systematic review. Of the 9 studies included, 2 used Samsung Galaxy smartphones, and 7 used wearable watch-like devices. A sphygmomanometer was used as a reference standard in all studies.
Conclusion: The current evidence base consists of small, biased, and low-quality studies which are insufficient to advise clinicians on the true value of PPG devices for AH detection. Further research is required with reference standards, standardized validation, and transparent algorithms for PPG technology to be used as a valid tool for early AH diagnosis.
Keywords
arterial hypertension; photoplethysmography; smart devices; wearable devices
About this articleTitle
Photoplethysmography technology use in smart devices for early diagnosis of arterial hypertension: a systematic review
Journal
Issue
Article type
Review paper
Published online
2023-12-12
Page views
129
Article views/downloads
93
DOI
Keywords
arterial hypertension
photoplethysmography
smart devices
wearable devices
Authors
Simona Andriekutė
Kamilė Bagdonaitė
Mažvydas Savickas
Kristina Ziutelienė
References (21)- Chan G, Cooper R, Hosanee M, et al. Multi-Site Photoplethysmography Technology for Blood Pressure Assessment: Challenges and Recommendations. J Clin Med. 2019; 8(11): 1827.
- World Health Organization. Hypertension. Health Topics. Hypertension. Available from: https://www.who.int/health-topics/hypertension#tab=tab_1.
- World Health Organization. Hypertension. Fact Sheets. https://www.who.int/news-room/fact-sheets/detail/hypertension.
- Arima H, Barzi F, Chalmers J. Mortality patterns in hypertension. J Hypertens. 2011; 29 Suppl 1: S3–S7.
- Welykholowa K, Hosanee M, Chan G, et al. Multimodal Photoplethysmography-Based Approaches for Improved Detection of Hypertension. J Clin Med. 2020; 9(4): 1203.
- Ganti V, Carek AM, Jung H, et al. Enabling Wearable Pulse Transit Time-Based Blood Pressure Estimation for Medically Underserved Areas and Health Equity: Comprehensive Evaluation Study. JMIR Mhealth Uhealth. 2021; 9(8): e27466.
- Holyoke P, Yogaratnam K, Kalles E. Web-Based Smartphone Algorithm for Calculating Blood Pressure From Photoplethysmography Remotely in a General Adult Population: Validation Study. J Med Internet Res. 2021; 23(4): e19187.
- Atomi K, Kawanaka H, Bhuiyan MB, et al. Cuffless Blood Pressure Estimation Based on Data-Oriented Continuous Health Monitoring System. Comput Math Methods Med 2017. Comput Math Methods Med. 2017; 1803485 .
- Liu J, Qiu S, Luo N, et al. PCA-Based Multi-Wavelength Photoplethysmography Algorithm for Cuffless Blood Pressure Measurement on Elderly Subjects. IEEE J Biomed Health Inform. 2021; 25(3): 663–673.
- Socrates T, Krisai P, Vischer AS, et al. Improved agreement and diagnostic accuracy of a cuffless 24-h blood pressure measurement device in clinical practice. Sci Rep. 2021; 11(1): 1143.
- Hsiao CC, Kuo HC, Lee RG, et al. Effects of pulse transit time and physiological differences on wearable device based blood pressure estimation. 2016 International Automatic Control Conference (CACS). 2016: 242–246.
- Dey J, Gaurav A, Tiwari VN. InstaBP: Cuff-less Blood Pressure Monitoring on Smartphone using Single PPG Sensor. Annu Int Conf IEEE Eng Med Biol Soc. 2018; 2018: 5002–5005.
- He Z, Chen X, Fang Z, Tang M et al. Cuff-less blood pressure estimation using Kalman filter on android platform. 2017 IEEE 19th International Conference on e-Health Networking, Applications and Services, Healthcom 2017, December 1–5.
- Jain M, Kumar N, Deb S. An affordable cuff-less blood pressure estimation solution. Annu Int Conf IEEE Eng Med Biol Soc. 2016; 2016: 5294–5297.
- Booth J. A short history of blood pressure measurement. Proc R Soc Med. 1977; 70(11): 793–799.
- Chandrasekhar A, Kim CS, Naji M, et al. Smartphone-based blood pressure monitoring via the oscillometric finger-pressing method. Sci Transl Med. 2018; 10(431).
- Elgendi M, Fletcher R, Liang Y, et al. The use of photoplethysmography for assessing hypertension. NPJ Dig Med. 2019; 2(1).
- Photoplethysmography (PPG). https://www.news-medical.net/health/Photoplethysmography-(PPG).aspx (21 Mar 2023).
- Allen J. Photoplethysmography and its application in clinical physiological measurement. Physiol Meas. 2007; 28(3): R1–39.
- Lee HY, Lee DJ, Seo J, et al. Korean Society of Hypertension. Smartphone / smartwatch-based cuffless blood pressure measurement : a position paper from the Korean Society of Hypertension. Clin Hypertens. 2021; 27(1): 4.
- Omboni S, McManus RJ, Bosworth HB, et al. Evidence and Recommendations on the Use of Telemedicine for the Management of Arterial Hypertension: An International Expert Position Paper. Hypertension. 2020; 76(5): 1368–1383.