The use of photoplethysmography for assessing hypertension
Open accessAbstract
The measurement of blood pressure (BP) is critical to the treatment and management of many medical conditions. High blood pressure is associated with many chronic disease conditions, and is a major source of mortality and morbidity around the world. For outpatient care as well as general health monitoring, there is great interest in being able to accurately and frequently measure BP outside of a clinical setting, using mobile or wearable devices. One possible solution is photoplethysmography (PPG), which is most commonly used in pulse oximetry in clinical settings for measuring oxygen saturation. PPG technology is becoming more readily available, inexpensive, convenient, and easily integrated into portable devices. Recent advances include the development of smartphones and wearable devices that collect pulse oximeter signals. In this article, we review (i) the state-of-the-art and the literature related to PPG signals collected by pulse oximeters, (ii) various theoretical approaches that have been adopted in PPG BP measurement studies, and (iii) the potential of PPG measurement devices as a wearable application. Past studies on changes in PPG signals and BP are highlighted, and the correlation between PPG signals and BP are discussed. We also review the combined use of features extracted from PPG and other physiological signals in estimating BP. Although the technology is not yet mature, it is anticipated that in the near future, accurate, continuous BP measurements may be available from mobile and wearable devices given their vast potential.
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The wavelength of light affects the PPG measurement because green light penetrates less deeply than red and infrared light.
“The wavelength of light also affects the PPG measurement [18] since green light penetrates less deeply than red and infrared light [51].”
From Wearable Photoplethysmography for Cardiovascular Monitoring (2022) · cites this paper as [18]
Beyond fitness and heart rate monitoring, the primary medical use of PPG has been focused on obtaining information about the cardiovascular system towards cardiovascular disease (CVD) diagnosis and treatment.
“Beyond fitness and heart rate monitoring, the primary medical use of the PPG has been focused on obtaining information about the cardiovascular system towards cardiovascular disease (CVD) diagnosis and treatment [17,18].”
From Sources of inaccuracy in photoplethysmography for continuous cardiovascular monitoring (2021) · cites this paper as [17]
Red light and NIR penetrate deeper into human body and provide a wider range of information about physiological signal.
“On the contrary, red light and NIR penetrate deeper into the human body and thus provide a wider range of information about the physiological signal [55,56].”
From The Current State of Optical Sensors in Medical Wearables (2022) · cites this paper as [55]
Many algorithms are known where systolic and diastolic BP are estimated from the shape of the PPG curve.
“Many algorithms are known where systolic and diastolic BP are estimated from the shape of the PPG curve [55,102].”
From The Current State of Optical Sensors in Medical Wearables (2022) · cites this paper as [55]
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Li, K., Cardoso, C., Moctezuma-Ramirez, A., Elgalad, A., & Perin, E. (2023) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph20247146 · Cited by 160 · see citing works
A Review of Wearable Multi-Wavelength Photoplethysmography
Ray, D., Collins, T., Woolley, S., & Ponnapalli, P. (2023) · IEEE Reviews in Biomedical Engineering · doi:10.1109/rbme.2021.3121476 · Cited by 155 · see citing works
Cuffless Single-Site Photoplethysmography for Blood Pressure Monitoring
Hosanee, M., Chan, G., Welykholowa, K., Cooper, R., Kyriacou, P. A., Zheng, D., Allen, J., Abbott, D., Menon, C., Lovell, N. H., et al. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9030723 · Cited by 136 · see citing works
Self-citationWearables in cardiology: Here to stay
Dagher, L., Shi, H., Zhao, Y., & Marrouche, N. F. (2020) · Heart Rhythm · doi:10.1016/j.hrthm.2020.02.023 · Cited by 107 · see citing works
The Current State of Optical Sensors in Medical Wearables
Vavrinsky, E., Esfahani, N. E., Hausner, M., Kuzma, A., Rezo, V., Donoval, M., & Kosnacova, H. (2022) · Biosensors · doi:10.3390/bios12040217 · Cited by 103 · see citing works
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2D Hybrid Perovskite Sensors for Environmental and Healthcare Monitoring
Riisnaes, K. J., Alshehri, M., Leontis, I., Mastria, R., Lam, H. T., De Marco, L., Coriolano, A., Craciun, M. F., & Russo, S. (2024) · ACS Applied Materials & Interfaces · doi:10.1021/acsami.4c02966 · Cited by 21 · see citing works
- Authors
- Elgendi, M., Fletcher, R., Liang, Y., Howard, N., Lovell, N. H., Abbott, D., Lim, K., & Ward, R.
- Affiliations
- University of British Columbia (CA)
- University of Massachusetts Chan Medical School (US)
- University of Oxford (GB)
- UNSW Sydney (AU)
- The University of Adelaide (AU)
- Corresponding author
- Elgendi, Mohamed
- ORCID
- Venue
- npj Digital Medicine
- Published
- 2019-06-26
- Volume
- 2
- Issue
- 1
- Pages
- 60-60
- ISSN
- 2398-6352 (ISSN-L)
- PMC
- PMC6594942
- OpenAlex
- W2955961229
- Cited by
- 625
- References
- 86
- Citations by year
- 2026: 70 · 2025: 89 · 2024: 87 · 2023: 112 · 2022: 111 · 2021: 94 · 2020: 55 · 2019: 6
- FWCI
- 5.35
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- npj Digital Medicine (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- UNSWorks (UNSW Sydney) (submittedVersion, cc-by)
- Funders
- Children's Hospital Foundation
- BC Children's Hospital
- Topics
- Physical Sciences › Engineering › Biomedical Engineering › Non-Invasive Vital Sign Monitoring
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Disease Prevention
- Health Sciences › Medicine › Surgery › Hemodynamic Monitoring and Therapy
- Keywords
- photoplethysmography, hypertension, blood pressure estimation, pulse oximetry, wearable devices, smartphone health monitoring, non-invasive blood pressure measurement, physiological signal fusion, continuous blood pressure monitoring
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