Oscillometric Blood Pressure Measurement: Modeling and Analysis of the Area Oscillogram and Height Oscillogram

Vishaal Dhamotharan¹Hao-min Cheng²Shih-Hsien Sung²Chen-Huan Chen²Cederick Landry³Mark Freithaler¹Aman Mahajan¹Sanjeev G Shroff¹Jin-Oh Hahn⁴Ramakrishna Mukkamala^1*

• ¹University of Pittsburgh, Pittsburgh, United States
• ²National Yang Ming Chiao Tung University, Hsinchu, Hsinchu County, Taiwan
• ³Université de Sherbrooke, Sherbrooke, Quebec, Canada
• ⁴University of Maryland, College Park, College Park, Maryland, United States

Objective: Oscillometry is the most popular blood pressure (BP) measurement method. Conventionally, BP is computed from the oscillation height versus cuff pressure function ("height oscillogram"). However, the oscillation shape also changes with cuff pressure. The objectives were to mathematically model oscillation shape and height variations as a function of cuff pressure and analyze these models using patient data. Methods: The patient data comprised oscillometric arm cuff pressure and invasive brachial BP waveforms from 109 patients with diverse BPs. The data were analyzed to show that the oscillation area versus cuff pressure function ("area oscillogram") in particular could be reliably constructed while offering distinct information to the height oscillogram. An analytical model of the area oscillogram was developed with four unknown parameters representing the widths of the brachial artery compliance curve over positive and negative transmural pressure ranges and systolic and diastolic BPs. With invasive systolic and diastolic BPs as inputs, this model and a previous height oscillogram model with the same four parameters, were evaluated in terms of fitting individual patient oscillograms. The impact of key assumptions of the models was evaluated as well. Results: The area and height oscillogram models fitted the patient data well with errors of 6.9±0.3% and 8.7±0.4%, respectively. Cuff-arm-artery viscoelasticity affected the height oscillogram model fitting, while cuff-arm system nonlinearity may affect area oscillogram model parameter estimates. Conclusion: Despite simplifying assumptions, the proposed area and previous height oscillogram models can reproduce measured patient oscillograms well. These models may ultimately help improve oscillometric BP measurement accuracy.