DEPARTMENT OF ENGINEERING SCIENCE

INSTITUTE OF BIOMEDICAL ENGINEERING

Monitoring Blood Pressure

Biomedical Signal Processing
marco.pimentel@eng.ox.ac.u
k

Marco F Pimentel,
Graduate Student,
Centre for Doctoral Training in Healthcare Innovation,
Institute of Biomedical Engineering,
University of Oxford February 16, 2017
Outline
Short history
Definition of Blood Pressure
What is hypertension?

Various methods used for measurements of blood

pressure
How often should we measure blood pressure?
Sampling and Aliasing

New resources An Oxford University Project

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The first to measure BP

1733 - Reverend Stephen

Hales first to measure BP

Measured the height of a

column of blood after
cannulating the carotid
artery in a horse with a
brass pipe.

Im that
good!!!

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The first measurement of BP

The brass pipe was

attached to a 12 inch glass
tube

Tube was connected to the

pipe via a trachea of a
goose

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A second try

100 years later: a mercury manometer connected to the

artery was used to measure the BP

However:
Both of these methods are invasive

And maybe a
bit uncomfortable
for the patient!

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Eureka!

In late 1890s, an Italian physician Scipione Riva Rocci

invented the Sphygmomanometer

Shygmo (from the Greek) => pulse

Manometer => pressure meter

- Consisted of a mercury column

Manometer, a rubber sleeve which
is filled with air, and a squeeze bag
to inflate the rubber sleeve I had an
idea!

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Nowadays BP monitors

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What is Blood Pressure?

Blood Pressure is a measurement of the force against the

walls of the arteries as the heart pumps blood throughout
the body

Blood pressure is measured in mmHg (millimeters of

mercury)

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What is Blood Pressure?

Blood Pressure is a measurement of the force against the

walls of the arteries as the heart pumps blood throughout
the body

Blood pressure is measured in mmHg (millimeters of

mercury)

1,000 Pa is about 7 mmHg!

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What is Blood Pressure?

The blood pressure reading is taken in 2 numbers:

systolic and diastolic.
Measure of
pressure as the
heart is beating
Systolic

Diastolic Measure of
pressure while
the heart is at rest
between beating

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Hypertension

Blood pressure changes all the time:

It decreases when we sleep, or when we are at rest
It increases when we are active, excited, practicing sports,
stressed and nervous

Changing blood pressure is a vital part of a healthy

cardiovascular system

Hypertension, or high blood pressure, happens when the blood

pressure stays too high over an extended period of time:
Can cause the heart to have to work too hard and the force of
the blood flow can damage your arteries, heart, kidneys, brain
and eyes.

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Hypertension

Know your numbers:

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Hypertension

Hypertension depends on several factors:

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How to measure?
Invasive blood pressure (IBP):
Itmeasures the BP internally by using a sensitive IV
catheter inserted into an superficial artery. This is the
procedure taken where continuous BP monitoring is
required.

Non-invasive blood pressure (NIBP):

Auscultation

Oscillometry

Doppler (determines the flow distal to the artery)

Arterial
tonometry, Arterial volume clamp are other types of
NIBP measure

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How to measure?
Non-invasive blood pressure
Auscultation

Mercury sphygmomanometer Mechanical manometer

+ stethoscope + stethoscope

Oscillometry

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How to measure?

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The auscultation method

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The auscultation method

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The auscultation method

Systolic BP

Diastolic BP

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The oscillometric method

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 The oscillometric method

It is based on the
change of the
magnitude of
oscillation

MAP Mean
Arterial Pressure

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 The oscillometric method

It is based on the
change of the
magnitude of
oscillation

MAP Mean
Arterial Pressure

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How often should we measure?

Lets first consider an example

MATLAB Demo

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How often should we measure?

Why is this important for blood pressure monitoring?

How much does your blood pressure vary in one day?

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How often should we measure?

Why is this important for blood pressure monitoring?

How much does your blood pressure vary in one day?

Kotsis et al. Hypertension, 2005

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 How often should we measure?

BP

Treatment Treat
threshold
24hr mean Do not
SBP treat
DBP time
2pm
4am 8am 10pm 4am

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 How often should we measure?

BP Under-sampling

Treatment Treat
threshold
24hr mean + + Do not
+ treat
time
2pm
4am 8am 10pm 4am

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 How often should we measure?

BP Aliasing effect

Treatment Treat
threshold
+ + Do not
+ treat
time
2pm
4am 8am 10pm 4am

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Under-sampling and aliasing

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Sampling and Aliasing

Under-sampling looses (important) wave details!

It also may change the wave form/shape due to

Aliasing

Sampling is a discrete observation or

measurement, while Aliasing is an
illusion, appearance of something that is
not, due to shortcomings of sampling

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New resources

http://www.worldlifeexpectancy.com/cause-of-death/hypertension/by-country

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Low-cost BP monitor

http://code.google.com/p/ewh-bp-project/

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Low-cost BP monitor

http://code.google.com/p/ewh-bp-project/
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Awards

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 Break!

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