Cuffless Blood Pressure Monitoring and the Advent of a New Era in Medicine and Society

Abstract

Measurement of arterial blood pressure (BP) by the brachial cuff sphygmomanometer has been a cornerstone of modern medicine, and notwithstanding its limitations of intermittent BP monitoring, the cuff sphygmomanometer has not been surpassed by any other noninvasive methodology. However, advances in sensor technology for arterial pulse detection have paved the way for the potential development of devices for cuffless measurement of BP, with the prospect of continuous monitoring. Just as the cuff sphygmomanometer could be considered as having provided a significant step in establishing elevated BP as a major factor of cardiovascular risk since the turn of the twentieth century, cuffless BP monitoring might be considered a disruptive technology for continuous BP monitoring in healthy individuals during daily living and could become an integral component of modern digital health platforms in the twenty-first century. This volume of the Handbook of Cuffless Blood Pressure Monitoring addresses the significant challenges faced by this methodology. The underlying physiology and hemodynamic principles involved in the generation of the arterial pressure pulse are complemented by the clinical relevance of the novel cuffless methodologies in relation to the conventional cuff sphygmomanometer. The underlying pressure dependency of arterial properties, which is at the base of the cuffless technique employing pulse transit measurement as a surrogate measure of BP, is addressed in association with instrumentation, measurement techniques, calibration procedures, device validation and regulatory requirements. This book provides a timely and comprehensive platform on how to approach the critical question of whether cuffless is the future of BP monitoring.