Influence of Sex, BMI, and Skin Color on the Accuracy of Non-Invasive Cuffless Photoplethysmography-Based Blood Pressure Measurements

Arik Ben-Ishay³, Meir Fons³, Roei Merin³ and Yftach Gepner⁴* Nir Goldstein³, Dean Nachman^1,2†, Arik Eisenkraft^2,3†, Dean Nachman^1,2†, Arik Eisenkraft^2,3†, 

• ¹_{Heart Institute, Hadassah Ein Kerem Medical Center, Jerusalem, Israel}
• _{²Institute for Research in Military Medicine, Faculty of Medicine, The Hebrew University of Jerusalem and the Israel Defense Force Medical Corps, Jerusalem, Israel}
• _{³Biobeat Technologies LTD., Petach Tikva, Israel}
• _{⁴Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine and Sylvan Adams Sports Institute, Tel Aviv University, Tel-Aviv, Israel}

Vital signs obtained by photoplethysmography-based devices might be influenced by subcutaneous fat and skin color. This observational comparison study aimed to test the accuracy of blood pressure (BP) measurements between a photoplethysmography-based device and cuff-based BP device in ambulatory individuals, coming for a routine BP checkup. Systolic BP (SBP) and diastolic BP (DBP) measurements were stratified based on sex, BMI (<25; 25 ≤BMI<30; 30 ≤kg/m²), and skin color (types 1–3 and 4–6 by the Fitzpatrick scale). A total of 1548 measurements were analyzed. Correlations of SBP and DBP between the devices among males/females were between 0.914–0.987 (p < 0.001), and Bland-Altman analysis showed a bias of less than 0.5 mmHg for both sexes. Correlations of SBP and DBP between the devices among BMI groups were between 0.931–0.991 (p < 0.001), and Bland-Altman analysis showed a bias of less than 1 mmHg for all. Correlations of SBP and DBP between the devices among the skin color groups were between 0.936–0.983 (p < 0.001), and Bland-Altman analysis showed a bias of less than 1 mmHg for all. This study shows similar and high agreements between BP measurements obtained using a PPG-based non-invasive cuffless BP device and a cuff-based BP device across sex, BMI, and skin color groups.

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https://www.frontiersin.org/articles/10.3389/fphys.2022.911544/full?utm_source=FNTF&utm_medium=EMLX&utm_campaign=PRD_FEOPS_20170000_ARTICLE