Hypertension Diagnosis: A Review on Techniques to Measure Blood Pressure
Article Sidebar
Main Article Content
Abstract
Hypertension is both a symptom and a cause of health complications. The consequences of long-term hypertension are more documented than short-term hypertension, so detection methods emphasize the presence of long-term hypertension. These methods require confirmation of consistently high blood pressure. Thus, established methods require long-term observation of the patient, which poses the risk of starting treatment too late for effective mitigation. These methods are also not portable enough for long-term observation to be comfortable. The goals of on-going research into detection of hypertension are the confirmation of hypertension with shorter durations of observation, and comfortable and convenient methods of frequent blood pressure checks. Future methods that are promising include wearable non-auscultatory sensors, AI-assisted comparisons of short-term observation data against databases of readings, and small implants.
[Manuscript received: 14 Jun 2024 | Accepted: 3 Sep 2024 | Published: : 30 Sep 2024]
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
References
S. Oparil, M.C. Acelajado, G.L. Bakris, D.R. Berlowitz, R. Cífková, A.F. Dominiczak, G. Grassi, J. Jordan, N.R. Poulter, A. Rodgers and P.K. Whelton, “Hypertension,” Nature Reviews: Disease Primers, vol. 4, no. 18014, pp. 1-48, 2019.
DOI: https://doi.org/10.1038/nrdp.2018.14
J. Martín-Fernández, T. Alonso-Safont, E. Polentinos-Castro, M. D. Esteban-Vasallo, G. Ariza-Cardiel, M.I. González-Anglada, L. Sánchez-Perruca, G. Rodríguez-Martínez, R. Rotaeche-del-Campo and A. Bilbao-González “Impact of hypertension diagnosis on morbidity and mortality: a retrospective cohort study in primary care,” BMC Primary Care, vol. 24, no. 79, pp. 1-9, 2023.
DOI: https://doi.org/10.1186/s12875-023-02036-2
M.P. Koeners, K.E. Lewis, A.P. Ford and J.F.R. Paton, “Hypertension: a problem of organ blood flow supply–demand mismatch,” Future Cardiology, vol. 12, no. 3, pp. 339–349, 2016. DOI: https://doi.org/10.2217/fca.16.5
R. Baker, A. Wilson, K. Nockels, S. Agarwal, P. Modi and J. Bankart, “Levels of detection of hypertension in primary medical care and interventions to improve detection: a systematic review of the evidence since 2000,” BMJ Open, vol. 8, no. 3, pp. e019965, 2018.
DOI: https://doi.org/10.1136/bmjopen-2017-019965
A.N. Desai, “High blood pressure,” Journal of the American Medical Association, vol. 324, no. 12, pp. 1254-1255, 2022.
DOI: https://doi.org/10.1001/jama.2020.11289
A. Coca, C. Borghi, G.S. Stergiou, J. Blacher, C. Lee, A. Tricotel, A. Castelo-Branco, I. Khan, and M. Abdel-Moneim, “Long-term event rates, risk factors, and treatment pattern in patients qualifying for dual blood pressure-lowering therapy: an observational study in 1.4 million individuals,” Journal of Hypertension, vol. 41, no. 3, pp. e29-e30, 2023.
DOI: https://doi.org/10.1097/01.hjh.0000939140.38251.59
NCD-RisC, “Long-term and recent trends in hypertension awareness, treatment, and control in 12 high-income countries: an analysis of 123 nationally representative surveys,” The Lancet, vol. 394, no. 10199, pp. 639-651, 2019.
DOI: https://doi.org/10.1016/S0140-6736(19)31145-6
R. Philip, T. Beaney, N. Appelbaum, C.R. Gonzalvez, C. Koldeweij, A.K. Golestaneh, N. Poulter and J.M. Clarke, “Variation in hypertension clinical practice guidelines: a global comparison,” BioMed Central (BMC) Medicine, vol. 19, no. 117, pp. 1-13, 2021.
DOI: https://doi.org/10.1186/s12916-021-01963-0
B. Zhou, P. Perel, G.A. Mensah and M. Ezzati, “Global epidemiology, health burden and effective interventions for elevated blood pressure and hypertension,” Nature Reviews Cardiology, vol. 18, no. 11, pp. 785-802, 2021.
DOI: https://doi.org/ 10.1038/s41569-021-00559-8
B-M. Schmidt, S. Durao, I. Toews, C.M. Bavuma, A. Hohlfeld, E. Nury, J.J. Meerpohl and T. Kredo, “Screening strategies for hypertension,” Cochrane Database of Systematic Reviews, vol. 5, no. 5, 2020.
DOI: https://doi.org/10.1002/14651858.CD013212.pub2
M-Y. Rhee, M. Munakata, D-Y. Nah, J.S. Kim and H-Y. Kim, “Home blood pressure measurement for hypertension management in the real world: Do not just measure, but share with your physician,” Frontiers in Cardiovascular Medicine, vol. 10, no. 1103216, pp. 1-10, 2023.
DOI: https://doi.org/10.3389/fcvm.2023.1103216
G. Parati, C. Lombardi, M. Pengo, G. Bilo and J.E. Ochoa, “Current challenges for hypertension management: From better hypertension diagnosis to improved patients' adherence and blood pressure control,” International Journal of Cardiology, vol. 331, pp. 262-269, 2021.
DOI: https://doi.org/10.1016/j.ijcard.2021.01.070
K.B. Bryant, M.B. Green, D. Shimbo, J.E. Schwartz, I.M. Kronish, Y. Zhang, J.P. Sheppard, R.J. McManus, A.E. Moran and B.K. Bellows, “Home blood pressure monitoring for hypertension diagnosis by current recommendations: a long way to go,” Hypertension, vol. 79, no. 2, pp. e15-e17, 2022.
DOI: https://doi.org/10.1161/HYPERTENSIONAHA.121.18463
A.E. Schutte, N.S. Venkateshmurthy, S. Mohan and D. Prabhakaran, “Hypertension in low- and middle-income countries,” Circulation Research, vol. 128, no. 7, pp. 808–826, 2021.
DOI: https://doi.org/10.1161/CIRCRESAHA.120.318729
M. Tinawi, “New trends in the diagnosis and management of hypertension,” Cureus, vol. 14, no. 2, pp. e22393, 2022.
DOI: https://doi.org/10.7759/cureus.22393
S. Wu, Y. Xu, R. Zheng, J. Lu, M. Li, L. Chen, Y. Huo, M. Xu, T. Wang, Z. Zhao, S. Wang, H. Lin, M. Dai, D. Zhang, J. Niu, G. Qin, L. Yan, Q. Wan, L. Chen, L. Shi, R. Hu, X. Tang, Q. Su, X. Yu, Y. Qin, G. Chen, Z. Gao, G. Wang, F. Shen, Z. Luo, Y. Chen, Y. Zhang, C. Liu, Y. Wang, S. Wu, T. Yang, Q. Li, Y. Mu, J. Zhao, Y. Bi, W. Wang and G. Ning, “Hypertension defined by 2017 ACC/AHA guideline, ideal cardiovascular health metrics, and risk of cardiovascular disease: a nationwide prospective cohort study,” The Lancet Regional Health – Western Pacific, vol. 20, pp. 100350, 2022.
DOI: https://doi.org/10.1016/j.lanwpc.2021.100350
C. Xu, M. Li, W. Meng, J. Han, S. Zhao, J. Tang, H. Yang, R. Maimaitiaili, J. Teliewubai, S. Yu, C. Chi, X. Fan, J. Xiong, Y. Zhao, Y. Xu and Y. Zhang, “Etiological diagnosis and personalized therapy for hypertension: a hypothesis of the reasoh classification,” Journal of Personalized Medicine, vol. 13, no. 2, pp. 261, 2023.
DOI: https://doi.org/10.3390/jpm13020261
R.M. Carey, J.T. Wright, S.J. Taler and P.K. Whelton, “Guideline-driven management of hypertension: an evidence-based update,” Circulation Research, vol. 128, no. 7, pp. 827–846, 2021.
DOI: https://doi.org/10.1161/CIRCRESAHA.121.318083
B.B. Green, M.L. Anderson, J. Campbell, A.J. Cook, K. Ehrlich, S. Evers, Y.N. Hall, C. Hsu, D. Joseph, P. Klasnja, K.L. Margolis, J.B. McClure, S.A. Munson and M.J. Thompson, “Blood pressure checks and diagnosing hypertension (BP-CHECK): design and methods of a randomized controlled diagnostic study comparing clinic, home, kiosk, and 24-hour ambulatory bp monitoring,” Contemporary Clinical Trials, vol. 79, pp. 1-13, 2019.
DOI: https://doi.org/10.1016/j.cct.2019.01.003
N.R. Jones, T. McCormack, M. Constanti and R.J. McManus, “Diagnosis and management of hypertension in adults: NICE guideline update 2019,” British Journal of General Practice, vol. 70, no. 691, pp. 90-91, 2020.
DOI: https://doi.org/10.3399/bjgp20X708053
S.S. Mousavi, M.A. Reyna, G.D. Clifford and R. Sameni, “A Survey on Blood Pressure Measurement Technologies: Addressing Potential Sources of Bias,” Sensors, vol. 24, no. 6, pp. 1730, 2024.
DOI: https://doi.org/10.3390/s24061730
M. Adrian, O. Borgquist, T. Kröger, E. Linné, P. Bentzer, M. Spångfors, J. Åkeson, A. Holmström, R. Linnér and T. Kander, “Mechanical complications after central venous catheterisation in the ultrasound-guided era: a prospective multicentre cohort study,” British Journal of Anaesthesia, vol. 129, no. 6, pp. 843-850, 2022.
DOI: https://doi.org/10.1016/j.bja.2022.08.036
Z-B. Zhou, T-R. Cui, D. Li, J-M. Jian, Z. Li, S-R. Ji, X. Li, J-D. Xu, H-F. Liu, Y. Yang, and T-L. Ren, “Wearable continuous blood pressure monitoring devices based on pulse wave transit time and pulse arrival time: a review,” Materials, vol. 16, no. 6, pp. 2133, 2023.
DOI: https://doi.org/10.3390/ma16062133
V. Del-Río-Guerrero, L-A. Martínez-Martínez, K. Arias-Callejas, N. Carbonell-Bobadilla, A. Mejía-Segura, G. Azamar-Morales, A. Espinosa-Orantes, J-R. Molina-Sánchez, M. Mora-Ramírez, M-F. Mejía-Ávila, A.V. Guerrero, L.H. Silveira and M. Martínez-Lavín, “The value of inquiring patients about local discomfort during blood pressure measurement for fibromyalgia detection. A cross-sectional study,” Seminars in Arthritis and Rheumatism, vol. 61, pp. 152218, 2023.
DOI: https://doi.org/10.1016/j.semarthrit.2023.152218
L.P. Hong and B.G. Kok, “Development of continuous blood pressure measurement system using photoplethysmograph and pulse transit time,” International Journal on Robotics, Automation and Sciences, vol. 3, pp. 8-13, 2021.
DOI: https://doi.org/10.33093/ijoras.2021.3.2
T. Tamura, “Current progress of photoplethysmography and SPO2 for health monitoring,” Biomedical Engineering Letters, vol. 9, no. 1, pp. 21-36, 2019.
DOI: https://doi.org/10.1007/s13534-019-00097-w
S. Marinari, P. Volpe, M. Simoni, M. Aventaggiato, F. De Benedetto, S. Nardini, C.M. Sanguinetti and P. Palange, “Accuracy of a new pulse oximetry in detection of arterial oxygen saturation and heart rate measurements: the SOMBRERO study,” Sensors, vol. 22, no. 13, pp. 5031, 2022.
DOI: https://doi.org/10.3390/s22135031
S. Sun, E. Bresch, J. Muehlsteff, L. Schmitt, X. Long, R. Bezemer, I. Paulussen, G.J. Noordergraaf and R.M. Aarts, “Systolic blood pressure estimation using ECG and PPG in patients undergoing surgery,” Biomedical Signal Processing and Control, vol. 79, no. 1, pp. 104040, 2023.
DOI: https://doi.org/10.1016/j.bspc.2022.104040
K. Bird, G. Chan, H. Lu, H. Greeff, J. Allen, D. Abbott, C. Menon, N.H. Lovell, N. Howard, W.S. Chan, R.R. Fletcher, A. Alian, R. Ward and M. Elgendi, “Assessment of hypertension using clinical electrocardiogram features: a first-ever review,” Frontiers in Medicine (Lausanne), vol. 7, pp. 583331, 2020.
DOI: https://doi.org/10.3389/fmed.2020.583331
R.P. Schnall, J.K. Sheffy and T. Penzel, “Peripheral arterial tonometry–PAT technology,” Sleep Medicine Reviews, vol. 61, pp. 101566, 2022.
DOI: https://doi.org/10.1016/j.smrv.2021.101566
K.V.D. Maele, R. Devlieger. S. Provyn, J.D. Schepper and I. Gies, “Feasibility and tolerance of fingertip peripheral arterial tonometry measurements in school-aged children,” Frontiers in Pediatrics, vol. 9, pp. 622056, 2021.
DOI: https://doi.org/10.3389/fped.2021.622056
G. Ogedegbe and T. Pickering, “Principles and techniques of blood pressure measurement,” Cardiology Clinics, vol. 28, no.4, pp. 571-586, 2010.
DOI: https://doi.org/10.1016/j.ccl.2010.07.006
C.F. Babbs, “Oscillometric measurement of systolic and diastolic blood pressures validated in a physiologic mathematical model,” BioMedical Engineering OnLine, vol. 11, pp. 56, 2012.
DOI: https://doi.org/10.1186/1475-925X-11-56
J.E. Sharman, I. Tan, G.S. Stergiou, C. Lombardi, F. Saladini, M. Butlin, R. Padwal, K. Asayama, A. Avolio, T.M. Brady, A. Murray and G. Parati, “Automated ‘oscillometric’ blood pressure measuring devices: how they work and what they measure,” Journal of Human Hypertension, vol. 37, pp. 93-100, 2023.
DOI: https://doi.org/10.1038/s41371-022-00693-x
T.E. Kottke, J.P. Anderson, J.D. Zillhardt, J.M. Sperl-Hillen, P.J. O’Connor, B.B. Green, R.A. Williams, B.M. Averbeck, M.N. Stiffman, M. Beran, M. Rakotz and K.L. Margolis, “Association of an automated blood pressure measurement quality improvement program with terminal digit preference and recorded mean blood pressure in 11 clinics,” JAMA Network Open, vol. 5, no. 8, pp. e2229098, 2022.
DOI: https://doi.org/10.1001/jamanetworkopen.2022.29098
M. Simjanoska, M. Gjoreski, M. Gams and A.M. Bogdanova, “Non-Invasive blood pressure estimation from ECG using machine learning techniques,” Sensors, vol. 18, no. 4, pp. 1160, 2018.
DOI: https://doi.org/10.3390/s18041160
C. Landry and R. Mukkamala, “Current evidence suggests that estimating blood pressure from convenient ECG waveforms alone is not viable,” Journal of Electrocardiology, vol. 81, pp. 153-155, 2023.
DOI: https://doi.org/10.1016/j.jelectrocard.2023.09.001
C. Wuerich, F. Wichum, O. El-Kadri, K. Ghantawi, N. Grewal, C. Wiede and K. Seidl, “Blood pressure estimation based on electrocardiograms,” Current Directions in Biomedical Engineering, vol. 8, no. 2, pp. 53-56, 2022.
DOI: https://doi.org/10.1515/cdbme-2022-1015
V.J.S. Leong and K.B. Gan, “Cuffless non-invasive blood pressure measurement using CNN-LSTM model: a correlation study,” International Journal on Robotics, Automation and Sciences, vol. 5, no. 2, pp. 25-32, 2023.
DOI: https://doi.org/10.33093/ijoras.2023.5.2.3
J.M. Guirguis-Blake, C.V. Evans, E.M. Webber, E.L. Coppola, L.A. Perdue and M.S. Weyrich, “Screening for hypertension in adults: updated evidence report and systematic review for the us preventive services task force,” Journal of the American Medical Association, vol. 325, no. 16, pp. 1657–1669, 2021.
DOI: https://doi.org/10.1001/jama.2020.21669
J. Tran, R. Norton, D. Canoy, J.R.A. Solares, N. Conrad, M. Nazarzadeh, F. Raimondi, G. Salimi-Khorshidi, A. Rodgers and K. Rahimi, “Multi-morbidity and blood pressure trajectories in hypertensive patients: A multiple landmark cohort study,” PLOS Medicine, vol.18, no. 6, pp. e1003674, 2021.
DOI: https://doi.org/10.1371/journal.pmed.1003674
U. Raghavendra, J.E.W. Koh, A. Gudigar, A. Shetty, J. Samanth, G. Paramasivam, S. Jagadish, N.A. Kadri, M. Karatabak, Ö. Yildirim, N. Arunkumar and A.A. Ardakani, “Automated diagnosis and assessment of cardiac structural alteration in hypertension ultrasound images,” Contrast Media & Molecular Imaging, vol. 2022, pp. 5616939, 2022.
DOI: https://doi.org/10.1155/2022/5616939
A. Shere, O. Eletta and H. Goyal, “Circulating blood biomarkers in essential hypertension: a literature review,” Journal of Laboratory and Precision Medicine, vol. 2, pp. 99, 2017.
DOI: https://doi.org/10.21037/jlpm.2017.12.06
R. Siru, J.H. Conradie, M.J. Gillett and M.M. Page, “Approach to the diagnosis of secondary hypertension in adults,” Australian Prescriber, vol. 44, no. 5, pp. 165-169, 2021.
DOI: https://doi.org/10.18773/austprescr.2021.038
L.A. Geddes, M. Voelz, C. Combs, D. Reiner and C.F. Babbs, “Characterization of the oscillometric method for measuring indirect blood pressure,” Annals of Biomedical Engineering, vol. 10, pp. 271-280, 1982.
DOI: https://doi.org/10.1007/BF02367308
M.A. Almarshad, M.S. Islam, S. Al-Ahmadi and A.S. BaHammam, “Diagnostic features and potential applications of PPG signal in healthcare: a systematic review,” Healthcare, vol. 10, no. 3, pp. 547, 2022.
DOI: https://doi.org/10.3390/healthcare10030547
O.M. Lawal, A. Enikuomehin and F. Otubogun, “The diagnostic yield of routine electrocardiography in hypertension and implications for care in a Southwestern Nigerian Practice,” International Journal of General Medicine, vol. 2021, no. 14, pp. 1421-1427, 2021.
DOI: https://doi.org/10.2147/IJGM.S282117
Y. Honjol, V.S. Rajkumar, C. Parent-Harvey, K. Selvasandran, S. Kordlouie, M. Comeau-Gauthier, E. Harvey and G. Merle, “Current view and prospect: Implantable pressure sensors for health and surgical care,” Medical Devices and Sensors, vol. 3, no. 3, pp. e10068, 2020.