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

June 16, 2016

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

M F Pimentel

Blood Pressure - Biomedical Signal Processing

June 16, 2016

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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!!!

M F Pimentel

Blood Pressure - Biomedical Signal Processing

June 16, 2016

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The first measurement of BP

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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!

M F Pimentel

Blood Pressure - Biomedical Signal Processing

June 16, 2016

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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

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I had an
idea!

Blood Pressure - Biomedical Signal Processing

June 16, 2016

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Nowadays BP monitors

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Blood Pressure - Biomedical Signal Processing

June 16, 2016

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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)

M F Pimentel

Blood Pressure - Biomedical Signal Processing

June 16, 2016

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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!

M F Pimentel

Blood Pressure - Biomedical Signal Processing

June 16, 2016

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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

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Blood Pressure - Biomedical Signal Processing

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:

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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.

Blood Pressure - Biomedical Signal Processing

June 16, 2016

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Hypertension

Know your numbers:

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Blood Pressure - Biomedical Signal Processing

June 16, 2016

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Hypertension
Hypertension depends on several factors:

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Blood Pressure - Biomedical Signal Processing

June 16, 2016

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How to measure?
Invasive blood pressure (IBP):
It

measures 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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Blood Pressure - Biomedical Signal Processing

June 16, 2016

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How to measure?

Non-invasive blood pressure

Auscultation

Mercury sphygmomanometer
+ stethoscope

Mechanical manometer
+ stethoscope

Oscillometry

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Blood Pressure - Biomedical Signal Processing

June 16, 2016

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How to measure?

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Blood Pressure - Biomedical Signal Processing

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The auscultation method

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Blood Pressure - Biomedical Signal Processing

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The auscultation method

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Blood Pressure - Biomedical Signal Processing

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The auscultation method

Systolic BP
Diastolic BP

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Blood Pressure - Biomedical Signal Processing

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The oscillometric method

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Blood Pressure - Biomedical Signal Processing

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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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Blood Pressure - Biomedical Signal Processing

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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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Blood Pressure - Biomedical Signal Processing

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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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Blood Pressure - Biomedical Signal Processing

June 16, 2016

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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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Blood Pressure - Biomedical Signal Processing

June 16, 2016

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How often should we measure?

BP

Treat

Treatment
threshold
24hr mean

SBP
DBP
4am
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Do not
treat
8am

2pm
Blood Pressure - Biomedical Signal Processing

time
10pm 4am
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How often should we measure?

Under-sampling

BP

Treatment
threshold
24hr mean

4am
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Treat

+
8am

2pm
Blood Pressure - Biomedical Signal Processing

Do not
treat

time
10pm 4am
June 16, 2016
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How often should we measure?

Aliasing effect

BP

Treatment
threshold

4am
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Treat

+
8am

2pm
Blood Pressure - Biomedical Signal Processing

Do not
treat

time
10pm 4am
June 16, 2016
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Under-sampling and aliasing

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Blood Pressure - Biomedical Signal Processing

June 16, 2016

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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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Blood Pressure - Biomedical Signal Processing

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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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Blood Pressure - Biomedical Signal Processing

June 16, 2016

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Awards

M F Pimentel

Blood Pressure - Biomedical Signal Processing

June 16, 2016

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Break!

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