Abstract
The markers that help to predict th function of a cardiovascular system are hemodynamic parameters like blood pressure (BP), stroke volume, heart rate, and cardiac output. Continuous analysis of hemodynamic parameters such as BP can detect abnormalities earlier, preventing cardiovascular diseases (CVDs). However, sometimes due to motion artifacts, it becomes difficult to monitor the BP accurately and classify it. This work presents an optimized deep learning model having the capability to estimate the systolic blood pressure (SBP) and diastolic blood pressure (DBP) and classify the BP stages simultaneously from the same network using only a single channel photoplethysmography (PPG) signal. The proposed model is designed by exploiting the deep learning framework of a convolutional neural network (CNN), exhibiting the inherent ability to extract features automatically. Moreover, the proposed framework utilizes the superlet transform method to transform a 1-D PPG signal into a 2-D super-resolution time–frequency (TF) spectrogram. A superlet transform separates the peaks related to true PPG signal components and motion artifacts components. Thus, the superlet provides a robust realtime approach to accurately estimating and classifying BP using a single PPG sensor signal and does not require additional ECG and PPG sensor signals for reference. Using a super-resolution spectrogram and CNN model makes the method profitable in motion artifact removal, feature selection, and extraction. Hence the proposed framework becomes less complex for deployment on wearable devices having limited battery resources. The performance of the proposed framework is demonstrated on the publicly available larger dataset MIMIC-III. This work obtained a mean absolute error (MAE) of 2.71 mmHg and 2.42 mmHg for SBP and DBP, respectively. The classification accuracy for the SBP prediction is about 96.79%, whereas it is 98.94% for DBP. From a motion artifact-affected PPG signal, SBP and DBP are estimated. Then the estimated BP is classified into three categories: normotension, prehypertension, and hypertension, and is compared with the state of art methods to show the effectiveness of the proposed optimized framework.








Similar content being viewed by others
Explore related subjects
Discover the latest articles and news from researchers in related subjects, suggested using machine learning.References
Esgalhado F, Fernandes B, Vassilenko V, Batista A, Russo S (2021) The application of deep learning algorithms for PPG signal processing and classification. Computers 10(12):1–15. https://doi.org/10.3390/computers10120158
Sharma M et al (2017) Cuff-less and continuous blood pressure monitoring: a methodological review. Technologies (Basel) 5(2):21. https://doi.org/10.3390/technologies5020021
Pankaj, Kumar A, Komaragiri R, Kumar M (2022) A review on computation methods used in photoplethysmography signal analysis for heart rate estimation. Arch Comput Methods Eng 29(2):921–940. https://doi.org/10.1007/s11831-021-09597-4
Ismail SNA, Nayan NA, Jaafar R, May Z (2022) Recent advances in non-invasive blood pressure monitoring and prediction using a machine learning approach. Sensors. https://doi.org/10.3390/s22166195
Pankaj, Kumar A, Komaragiri R, Kumar M (2023) Optimized deep neural network models for blood pressure classification using Fourier analysis-based time–frequency spectrogram of photoplethysmography signal. Biomed Eng Lett. https://doi.org/10.1007/s13534-023-00296-6
Wang R, Jia W, Mao ZH, Sclabassi RJ, Sun M (2014) Cuff-free blood pressure estimation using pulse transit time and heart rate. In: International conference on signal processing proceedings (ICSP). Institute of Electrical and Electronics Engineers Inc., pp 115–118. https://doi.org/10.1109/ICOSP.2014.7014980
Ganti VG, Carek AM, Nevius BN, Heller JA, Etemadi M, Inan OT (2021) Wearable cuff-less blood pressure estimation at home via pulse transit time. IEEE J Biomed Health Inform 25(6):1926–1937. https://doi.org/10.1109/JBHI.2020.3021532
Byfield R, Miller M, Miles J, Guidoboni G, Lin J (2022) Towards robust blood pressure estimation from pulse wave velocity measured by photoplethysmography sensors. IEEE Sens J 22(3):2475–2483. https://doi.org/10.1109/JSEN.2021.3134890
Fotiadis DI et al (2018) Biomedical and health informatics and the body sensor networks conferences, 4–7 March 2018, Treasure Island Hotel, Las Vegas
Liu W et al (2022) A wearable and flexible photoplethysmogram sensor patch for cuffless blood pressure estimation with high accuracy. IEEE Sens J 22(20):19818–19825. https://doi.org/10.1109/JSEN.2022.3202803
Yang S, Sohn J, Lee S, Lee J, Kim HC (2021) Estimation and validation of arterial blood pressure using photoplethysmogram morphology features in conjunction with pulse arrival time in large open databases. IEEE J Biomed Health Inform 25(4):1018–1030. https://doi.org/10.1109/JBHI.2020.3009658
Zhang Y, Zhang X, Cui P, Li S, Tang J (2021) Key feature selection and model analysis for blood pressure estimation from electrocardiogram, ballistocardiogram and photoplethysmogram. IEEE Access 9:54350–54359. https://doi.org/10.1109/ACCESS.2021.3070636
Li P, Laleg-Kirati TM (2021) Central blood pressure estimation from distal PPG measurement using semiclassical signal analysis features. IEEE Access 9:44963–44973. https://doi.org/10.1109/ACCESS.2021.3065576
Yao P et al (2022) Multi-dimensional feature combination method for continuous blood pressure measurement based on wrist PPG sensor. IEEE J Biomed Health Inform 26(8):3708–3719. https://doi.org/10.1109/JBHI.2022.3167059
Gupta S, Singh A, Sharma A, Tripathy RK (2022) Higher order derivative-based integrated model for cuff-less blood pressure estimation and stratification using PPG signals. IEEE Sens J 22(22):22030–22039. https://doi.org/10.1109/JSEN.2022.3211993
Dey J, Gaurav A, Tiwari VN (2018) InstaBP: cuff-less blood pressure monitoring on smartphone using single PPG sensor. In: Annual international conference of the IEEE engineering in medicine and biology—proceedings. https://doi.org/10.1109/EMBC.2018.8513189
Chakraborty A, Goswami D, Mukhopadhyay J, Chakrabarti S (2021) Measurement of arterial blood pressure through single-site acquisition of photoplethysmograph signal. IEEE Trans Instrum Meas. https://doi.org/10.1109/TIM.2020.3011304
Cardoso GS, Lucas MG, Cardoso SS, Ruzicki JCM, Junior AAS (2022) Using PPG and machine learning to measure blood pressure. In: Bastos-Filho TF, de Oliveira Caldeira EM, Frizera-Neto A (eds) XXVII Brazilian congress on biomedical engineering. Springer, Cham, pp 1909–1915
Wang D, Yang X, Liu X, Ma L, Li L, Wang W (2021) Photoplethysmography-based blood pressure estimation combining filter-wrapper collaborated feature selection with LASSO-LSTM Model. IEEE Trans Instrum Meas. https://doi.org/10.1109/TIM.2021.3109986
Ruiz-Rodríguez JC et al (2013) Innovative continuous non-invasive cuffless blood pressure monitoring based on photoplethysmography technology. Intensive Care Med. https://doi.org/10.1007/s00134-013-2964-2
Panwar M, Gautam A, Biswas D, Acharyya A (2020) PP-Net: a deep learning framework for PPG-based blood pressure and heart rate estimation. IEEE Sens J 20(17):10000–10011
Esgalhado F, Fernandes B, Vassilenko V, Batista A, Russo S (2021) The application of deep learning algorithms for ppg signal processing and classification. Computers. https://doi.org/10.3390/computers10120158
Chen Y, Zhang D, Karimi HR, Deng C, Yin W (2022) A new deep learning framework based on blood pressure range constraint for continuous cuffless BP estimation. Neural Netw 152:181–190
Yen CT, Chang SN, Liao CH (2022) Estimation of Beat-by-beat blood pressure and heart rate from ECG and PPG Using a fine-tuned deep CNN model. IEEE Access 10:85459–85469. https://doi.org/10.1109/ACCESS.2022.3195857
Leitner J, Chiang PH, Dey S (2022) Personalized blood pressure estimation using photoplethysmography: a transfer learning approach. IEEE J Biomed Health Inform 26(1):218–228. https://doi.org/10.1109/JBHI.2021.3085526
Wang W, Mohseni P, Kilgore KL, Najafizadeh L (2022) Cuff-less blood pressure estimation from photoplethysmography via visibility graph and transfer learning. IEEE J Biomed Health Inform 26(5):2075–2085. https://doi.org/10.1109/JBHI.2021.3128383
Song K, Chung KY, Chang JH (2020) Cuffless deep learning-based blood pressure estimation for smart wristwatches. IEEE Trans Instrum Meas 69(7):4292–4302. https://doi.org/10.1109/TIM.2019.2947103
Yen CT, Liao JX, Huang YK (2022) Applying a deep learning network in continuous physiological parameter estimation based on photoplethysmography sensor signals. IEEE Sens J 22(1):385–392. https://doi.org/10.1109/JSEN.2021.3126744
Athaya T, Choi S (2021) An estimation method of continuous non-invasive arterial blood pressure waveform using photoplethysmography: a u-net architecture-based approach. Sensors 21(5):1–18. https://doi.org/10.3390/s21051867
Kim DK, Kim YT, Kim H, Kim DJ (2022) DeepCNAP: a deep learning approach for continuous non-invasive arterial blood pressure monitoring using photoplethysmography. IEEE J Biomed Health Inform 26(8):3697–3707. https://doi.org/10.1109/JBHI.2022.3172514
Qiu S, Zhang YT, Lau SK, Zhao N (2022) Scenario adaptive cuffless blood pressure estimation by integrating cardiovascular coupling effects. IEEE J Biomed Health Inform. https://doi.org/10.1109/JBHI.2022.3227235
Pankaj, Kumar A, Komaragiri R, Kumar M (2023) A novel CS-NET architecture based on the unification of CNN, SVM and super-resolution spectrogram to monitor and classify blood pressure using photoplethysmography. Comput Methods Programs Biomed 240:107716. https://doi.org/10.1016/j.cmpb.2023.107716
Johnson AEW et al (2016) Data descriptor : MIMIC-III, a freely accessible critical care database. Sci Data 3:1–9
Arunkumar KR, Bhasker M (2020) Heart rate estimation from wrist-type photoplethysmography signals during physical exercise. Biomed Signal Process Control. https://doi.org/10.1016/j.bspc.2019.101790
Pankaj, Kumar A, Kumar M, Komaragiri R (2022) STSR: spectro-temporal super-resolution analysis of a reference signal less photoplethysmogram for heart rate estimation during physical activity. IEEE Trans Instrum Meas 71:1–10. https://doi.org/10.1109/TIM.2022.3192831
Tanveer MS, Hasan MK (2019) Cuffless blood pressure estimation from electrocardiogram and photoplethysmogram using waveform based ANN-LSTM network. Biomed Signal Process Control 51:382–392
Yan C et al (2019) Novel deep convolutional neural network for cuff-less blood pressure measurement using ECG and PPG signals. In: 2019 41st Annual international conference of the IEEE Engineering in Medicine and Biology Society (EMBC), IEEE, pp 1917–1920
Slapničar G, Mlakar N, Luštrek M (2019) Blood pressure estimation from photoplethysmogram using a spectro-temporal deep neural network. Sensors (Switzerland). https://doi.org/10.3390/s19153420
Baek S, Jang J, Yoon S (2019) End-to-end blood pressure prediction via fully convolutional networks. IEEE Access 7:185458–185468. https://doi.org/10.1109/ACCESS.2019.2960844
Eom H et al (2020) End-to-end deep learning architecture for continuous blood pressure estimation using attention mechanism. Sensors (Switzerland). https://doi.org/10.3390/s20082338
Hsu YC, Li YH, Chang CC, Harfiya LN (2020) Generalized deep neural network model for cuffless blood pressure estimation with photoplethysmogram signal only. Sensors (Switzerland) 20(19):1–18. https://doi.org/10.3390/s20195668
Li YH, Harfiya LN, Purwandari K, der Lin Y (2020) Real-time cuffless continuous blood pressure estimation using deep learning model. Sensors (Switzerland) 20(19):1–19. https://doi.org/10.3390/s20195606
Aguirre N, Grall-Maës E, Cymberknop LJ, Armentano RL (2021) Blood pressure morphology assessment from photoplethysmogram and demographic information using deep learning with attention mechanism. Sensors 21(6):1–19. https://doi.org/10.3390/s21062167
Lee D et al (2021) Beat-to-beat continuous blood pressure estimation using bidirectional long short-term memory network. Sensors (Switzerland) 21(1):1–15. https://doi.org/10.3390/s21010096
Harfiya LN, Chang CC, Li YH (2021) Continuous blood pressure estimation using exclusively photopletysmography by lstm-based signal-to-signal translation. Sensors. https://doi.org/10.3390/s21092952
Mahmud S et al (2022) A shallow U-Net architecture for reliably predicting blood pressure (BP) from photoplethysmogram (PPG) and electrocardiogram (ECG) signals. Sensors 22(3):919
Rastegar S, Gholam Hosseini H, Lowe A (2023) Hybrid CNN-SVR blood pressure estimation model using ECG and PPG signals. Sensors. https://doi.org/10.3390/s23031259
Nour M, Polat K, Şentürk Ü, Arıcan M (2023) A novel cuffless blood pressure prediction: uncovering new features and new hybrid ML models. Diagnostics. https://doi.org/10.3390/diagnostics13071278
Qin C, Li Y, Liu C, Ma X (2023) Cuff-less blood pressure prediction based on photoplethysmography and modified ResNet. Bioengineering 10(4):400. https://doi.org/10.3390/bioengineering10040400
Kachuee M, Kiani MM, Mohammadzade H, Shabany M (2017) Cuffless blood pressure estimation algorithms for continuous healthcare monitoring. IEEE Trans Biomed Eng 64(4):859–869. https://doi.org/10.1109/TBME.2016.2580904
El-Hajj C, Kyriacou PA (2021) Cuffless blood pressure estimation from PPG signals and its derivatives using deep learning models. Biomed Signal Process Control. https://doi.org/10.1016/j.bspc.2021.102984
Cheng J, Xu Y, Song R, Liu Y, Li C, Chen X (2021) Prediction of arterial blood pressure waveforms from photoplethysmogram signals via fully convolutional neural networks. Comput Biol Med 138:104877. https://doi.org/10.1016/j.compbiomed.2021.104877
Ibtehaz N, Rahman MS (2020) PPG2ABP: translating photoplethysmogram (PPG) signals to arterial blood pressure (ABP) waveforms using fully convolutional neural networks. ArXiv Preprint. https://arxiv.org/abs/2005.01669
Treebupachatsakul T, Boosamalee A, Shinnakerdchoke S, Pechprasarn S, Thongpance N (2022) Cuff-less blood pressure prediction from ECG and PPG signals using fourier transformation and amplitude randomization pre-processing for context aggregation network training. Biosensors (Basel). https://doi.org/10.3390/bios12030159
Funding
No funding available.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
All Authors of this work declare no conflict of interest.
Ethical approval
This article contains no studies with human participants or animals performed by authors.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law.
About this article
Cite this article
Pankaj, Kumar, A., Komaragiri, R. et al. Blood pressure estimation and classification using a reference signal-less photoplethysmography signal: a deep learning framework. Phys Eng Sci Med 46, 1589–1605 (2023). https://doi.org/10.1007/s13246-023-01322-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s13246-023-01322-8