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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Physiol. | doi: 10.3389/fphys.2019.01415

Formulas to Explain Popular Oscillometric Blood Pressure Estimation Algorithms

 Anand Chandraskehar1,  Mohammad Yavarimanesh1,  Jin-Oh Hahn2, Shih-Hsien Sung3, Chen-Huan Chen3, Hao-Min Cheng3 and  Ramakrishna Mukkamala1*
  • 1Michigan State University, United States
  • 2University of Maryland, College Park, United States
  • 3National Yang-Ming University, Taiwan

Oscillometry is the blood pressure (BP) measurement principle of most automatic cuff devices and may potentially be extended to achieve cuff-less BP monitoring. The oscillogram (blood volume oscillation amplitude-external pressure function) is measured, and BP is then estimated via an empirical algorithm. The objective was to establish formulas to explain popular empirical algorithms. A mathematical model of the oscillogram was developed and analyzed to derive parametric formulas for explaining the maximum amplitude, derivative, and fixed ratio algorithms. Exemplary parameter values were obtained by fitting the model to measured oscillograms. The model and formulas were validated by showing that their predictions correspond to measurements. The formula for the maximum amplitude algorithm indicates that it yields a weighted average of systolic and diastolic BP (0.45 and 0.55 weighting) instead of commonly assumed mean BP. The formulas for the derivative algorithm indicate that it can accurately estimate systolic and diastolic BP (<1.5 mmHg error), if oscillogram measurement noise can be obviated. The formulas for the fixed ratio algorithm indicate that it can yield inaccurate BP estimates, because the ratios change substantially (over a 0.5-0.6 range) with arterial compliance and pulse pressure and error in the assumed ratio translates to BP error via large amplification (>40). The established formulas allow for easy and complete interpretation of perhaps the three most popular oscillometric BP estimation algorithms while providing new insights. The model and formulas may provide a foundation for improving the accuracy of both automatic cuff and cuff-less BP measurement devices.

Keywords: arterial compliance, Blood pressure measurement, cuff devices, cuff-less devices, derivative oscillometry, fixed ratios, mathematical model, Oscillometry

Received: 16 Aug 2019; Accepted: 31 Oct 2019.

Copyright: © 2019 Chandraskehar, Yavarimanesh, Hahn, Sung, Chen, Cheng and Mukkamala. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Prof. Ramakrishna Mukkamala, Michigan State University, East Lansing, 48824, Michigan, United States,