ArticleEuropean journal of applied physiology2026
Validation study on cuffless ambulatory blood pressure monitoring method using bio-impedance, impedance cardiography and electrocardiography.
Article in European journal of applied physiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
purposeContinuous, non-invasive blood pressure (BP) monitoring is essential for understanding cardiovascular dynamics in real-world settings. This study evaluated the reliability and validity of a cuffless method for ambulatory BP monitoring using pulse wave travel times derived from bio-impedance, impedance cardiography, and electrocardiography. We examined whether this method can accurately estimate systolic and diastolic BP cross varying conditions.
methodsForty-one young, healthy participants completed a protocol involving postural changes, physical activity, and mental stress tasks. Pulse arrival time (PAT) and pulse transit time (PTT) were extracted, and person-specific models estimated BP using (1) all data of the person ('double-dipping') - used in most previous studies -, (2) half of a person's data (calibration), or (3) person-invariant parameters (calibration-free) which would enhance practical utility. Cuff-based BP served as the reference. Test-retest reliability, and construct and convergent validity were assessed.
resultsTest-retest reliability was high for PAT- and PTT-based BP for all approaches (ICC > 0.7), comparable to cuff-based measurements. Construct validity was generally poor: BP changes during physical activity were detected, but responses to mental stressors were not. Only double-dipping showed acceptable convergent validity, likely reflecting overfitting. In the calibration approach, convergence with cuff-based BP was moderate (MAE = 10.1-12.9 mmHg), with 59.2-68.5% of estimates within 10 mmHg of reference values. The strongest deterioration of convergentvalidity occurred with person-invariant models.
conclusionAlthough cuffless pulse wave travel time-based BP estimators showed strong reliability, validity was insufficient for clinical or stress research use, even with person-specific calibration. Future work should explore extended calibrationperiods before testing in naturalistic settings.
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