An instrument for measuring blood pressure and assessing cardiovascular health from the fingertip

Abstract

Despite blood pressure being one the leading modifiable risk factors for cardiovascular disease and death, it is severely under-monitored. For this challenge we propose a finger artery non-invasive tono-oscillometric monitor (FANTOM) which is an automated low-cost instrument for measuring blood pressure and hemodynamic parameters from the fingertip. The sensing technology is highly scalable and could be integrated to a pulse oximeter probe for increased patient comfort. A tonometric cuff-less mechatronic system is used to apply pressure on the fingertip for (i) measuring oscillometric blood pressure, (ii) recording arterial waveform and for (iii) constructing central blood pressure (CBP) waveform. Clinical study on volunteers (n = 33) was performed against a commercially available arm cuff device yielding systolic and diastolic readings ((mean±SD) mmHg) of (-0.9 ± 7.3) mmHg and (-3.3 ± 6.6) mmHg respectively. The results comply with the Association for the Advancement of Medical Instrumentation (AAMI) standard for non-invasive blood pressure monitors. The arterial pulse recording morphology was compared against a volume clamp device (CNSystems CNAP 500) (n = 3) resulting in similar performance. Comparison of CBP against a pulse wave analysis (PWA) device (Atcor Medical Sphygmocor XCEL) (n = 5) revealed central aortic systolic pulse (CASP) and central augmentation index (cAIx) estimates with precision and accuracy of (2.0 ± 3.7) mmHg and (1.4 ± 6.2)% respectively. In conclusion, the results indicate that the proposed technology could be useful in the development of new portable or wearable blood pressure monitors. The sensing technology is highly scalable and could be integrated to a pulse oximeter probe for increased patient comfort.

Keywords: Blood pressure; Central blood pressure; Fingertip; Oscillometric method; Tonometry.