Method and arrangement for blood pressure measurement

• US 6,443,905 B1
• Filed: 03/09/2000
• Issued: 09/03/2002
• Est. Priority Date: 09/12/1997
• Status: Expired due to Term

• Current Assignee: Polar Electro Oy
• Original Assignee: Polar Electro Oy
• Inventors: Niemimäki, Mika, Nissilä, Seppo, Sorvisto, Mika, Vieri-Gashi, Eija
• Primary Examiner(s): Shaver, Kevin
• Assistant Examiner(s): Natnithithadha, Navin
• Application Number:
  US09/508,354
• Time in Patent Office: 908 Days
• Field of Search: 600/481, 600/485, 600/490, 600/491, 600/492, 600/493, 600/494, 600/495, 600/496, 600/500, 600/501, 600/502, 600/503
• US Class Current: 600/490
• CPC Class Codes: A61B 5/0002 Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network A61B5/07 takes precedence; transmission systems for measured values G08C; transmission H04B; transmission of digital information H04L; wireless communication networks H04W
• CPC Class Codes: A61B 5/022 by applying pressure to close blood vessels, e.g. against the skin; Ophthalmodynamometers
• CPC Class Codes: A61B 5/02225 using the oscillometric method
• CPC Class Codes: A61B 5/681 Wristwatch-type devices

Abstract

The invention relates to a method and arrangement for blood pressure measurement. In the method, a variable compressive acting pressure is applied to a measuring point, such as a person'"'"'s extremity at a compression point by a pressure generator, and at the same time the effect of the variable pressure on the artery is measured at a second point, the second point being located farther away from the heart, i.e. closer to the end point of peripheral circulation than the compression point to which the pressure is applied. In the method diastolic pressure (PDIAS) and/or systolic pressure (PSYS) is determined as a result of an actual measurement. In addition, the method further includes an estimation cycle for the actual measurement, during which the magnitude of the pressure pulse is measured by a sensor measuring a pressure pulse signal, and in the estimation one or more statistical parameters are calculated from the pressure pulse measurement data to represent the magnitude of pressure pulse variation for forecasting and/or depicting the quality of the actual blood pressure measurement.

Claims

1. A method for blood pressure measurement, the method comprising applying a variable compressive acting pressure to a measuring point, such as a person'"'"'s extremity or the like, at a compression point by a pressure generator, and at the same time measuring the effect of the variable pressure on the artery at a second point located farther away from the heart, i.e. closer to the end point of peripheral circulation than the compression point to which the pressure is applied, wherein diastolic pressure (PDIAS) and/or systolic pressure (PSYS) is determined as a result of an actual blood pressure measurement,

characterized in that in addition to the actual blood pressure measurement, the method comprises using an estimation cycle for the actual measurement, during which the magnitude of a pressure pulse is measured by a sensor measuring a pressure pulse signal, and that one or more statistical parameters are calculated from the pressure pulse measurement data to represent the magnitude of pressure pulse variation for forecasting and/or depicting the quality of the actual blood pressure measurement.

3. A method as claimed in claim 1, characterized in that the estimation cycle either precedes or succeeds the actual blood pressure measurement or both precedes and succeeds the actual blood pressure measurement.

4. A method as claimed in claim 1, characterized in that if the estimation result surpasses reference values set for the quality of the actual blood pressure measurement, the actual blood pressure measurement is initiated, or the result of a performed actual measurement is accepted as the final result of the actual blood pressure measurement.

5. A method as claimed in claim 1, characterized in that if the estimation result is worse than reference values set for the quality of the actual blood pressure measurement, the actual blood pressure measurement is not initiated, or the result of a performed actual measurement is not accepted as the final result of the actual blood pressure measurement.

6. A method as claimed in claim 1, characterized by calculating one or more statistical parameters from the estimation cycle measurements:

maximum, minimum, magnitude of pressure pulse signal amplitude variation, standard deviation of pressure pulse signal amplitude variation, standard deviation and/or mean of the absolute maximums (ABSMAX) of the pressure pulse signal, standard deviation and/or mean of the absolute minimums (ABSMIN) of the pressure pulse signal, standard deviation and/or mean of the local maximums (LMAX) of the pressure pulse signal, standard deviation and/or mean of the local minimums (LMIN) of the pressure pulse signal.

7. A method as claimed in claim 6, characterized in that the magnitude of the person'"'"'s normal blood pressure variation owing to physiological or other reasons is determined in the estimation by means of one or more calculated statistical parameters.

8. A method as claimed in claim 7, characterized in that the normal range of variation in the blood pressure is determined on the basis of the magnitude of the normal variation in the blood pressure.

9. A method as claimed in claim 1, characterized in that the result of the estimation cycle is shown on a display.

10. A method as claimed in claim 1, characterized in that the result of the estimation cycle is shown together with the result of the actual blood pressure measurement.

11. A method as claimed in claim 1, characterized in that the reliability of the measurement result of the actual blood pressure measurement is estimated in the estimation of the quality of the actual blood pressure measurement which is performed on the basis of the measurements of the estimation cycle.

12. A method as claimed in claim 1, characterized in that a measurement-specific range of reliability for the measurement result of the actual blood pressure measurement is generated as a result of the estimation of the quality of the actual blood pressure measurement.

13. A method as claimed in claim 1, characterized in that the accuracy of the measurement result of the actual blood pressure measurement is estimated in the estimation of the quality of the actual blood pressure measurement which is performed on the basis of the measurements of the estimation cycle.

14. A method as claimed in claim 13, characterized in that a range of error is formed as a result of the estimation of the accuracy of the measurement result of the actual blood pressure measurement.

15. A method as claimed in claim 1, characterized in that the discrete representativeness of the measurement is estimated on the basis of the measurements of the estimation cycle.

16. A method as claimed in claim 1, characterized in that in one or more estimation cycles, an estimate is made as to whether the blood pressure value shows a trend towards a higher or lower value in the estimation cycle or if the trend is essentially indicative of a stable blood pressure value.

17. A method as claimed in claim 16, characterized in that the estimate of the occurrence of the trend is made by comparing the measurement data of two or more estimation cycles.

18. A method as claimed in claim 1, characterized in that the pressure pulse to be measured in the estimation cycle and the effect of the variable acting pressure on the artery to be measured in the actual blood pressure measurement are both made in the same area, i.e. farther away from the heart, or closer to the end point of peripheral circulation than the compression point, to which the pressure is applied in the actual blood pressure measurement.

19. A method as claimed in claim 1, characterized in that the pressure pulse measurement in the estimation cycle and the measurement of the effect of the pressure in the actual blood pressure measurement, also performed as pressure pulse measurement, are made by the same sensor.

20. A method as claimed in claim 1, characterized in that in the estimation cycle the pressure pulse is measured in the area of the radial artery.

21. A method as claimed in claim 1, characterized in that in the estimation cycle the measurement is carried out for a period of at least 20 seconds.

22. A method as claimed in claim 1, characterized in that the pressure pulse is measured as a multichannel measurement.

23. A method as claimed in claim 1, characterized in that the pressure pulse signal measured by the pressure pulse measuring sensor is amplified and filtered, and then subjected to A/D conversion.

24. A method as claimed in claim 1, characterized by observing the pressure pulse signal measurement in the estimation cycle (EC) and the pressure pulse signal measurement in the actual blood pressure measurement cycle (MC) as comparable measurements with regard to time, and by determining the point where the instant of determining the diastolic pressure (PDIAS) in the actual blood pressure measurement is located in relation to upper and lower peaks of a pressure pulse signal variation signal (S) generated on the basis of the estimation cycle (EC) measurement.

25. A method as claimed in claim 1, characterized by observing the pressure pulse signal measurement of the estimation cycle (EC) and the pressure pulse signal measurement of the actual blood pressure measurement cycle (MC) as comparable measurements with respect to time, and by determining the point where the instant of determining the systolic pressure (PSYS) of the actual blood pressure measurement is located in relation to upper and lower peaks of a pressure pulse signal variation signal (S) estimated on the basis of the estimation cycle measurement (EC).

26. A method as claimed in claim 24, characterized in that said upper and lower peaks are upper and lower peaks of a variation signal (S) generated from the absolute maximums (ABSMAX) of the pressure pulse signal (S) measured in the estimation.

27. A method as claimed in claim 24, characterized in that said upper and lower peaks are upper and lower peaks of a variation signal (S) generated from the absolute minimums (ABSMIN) of the pressure pulse signal (S) measured in the estimation.

28. A method as claimed in claim 24, characterized in that said upper and lower peaks are upper and lower peaks of a variation signal (S) generated from the local maximums (LMAX) of the pressure pulse signal (S) measured in the estimation.

29. A method as claimed in claim 24, characterized in that said upper and lower peaks are upper and lower peaks of a variation signal (S) generated from the local minimums (LMIN) of the pressure pulse signal (S) measured in the estimation.

30. A method as claimed in claim 24, characterized in that said upper and lower peaks are upper and lower peaks of a variation signal (S) generated from desired combinations of the absolute maximums (ABSMAX), absolute minimums (ABSMIN), local maximums (LMAX), local minimums (LMIN) of the pressure pulse signal or other corresponding signal points.

2. A method for blood pressure measurement, the method comprising applying a variable compressive acting pressure to a measuring point, such as a person'"'"'s extremity or the like, at a compression point by a pressure generator, determining diastolic pressure (PDIAS) and/or systolic pressure (PSYS) oscillometrically to determine the measurement result of an actual blood pressure measurement by measuring a pressure oscillation signal which is measurable from the pressure generator,

characterized in that in addition to the actual blood pressure measurement, the method comprises using an estimation cycle for the actual measurement, during which the magnitude of the pressure oscillation signal is measured by a sensor measuring the pressure oscillation signal, and that one or more statistical parameters are calculated from the pressure oscillation signal measurement data to represent the magnitude of pressure oscillation signal variation for forecasting and/or depicting the quality of the actual blood pressure measurement.

31. An arrangement for blood pressure measurement, comprising:

a pressure generator for applying an acting pressure to a measuring point, such as a person'"'"'s extremity or the like,

a measuring element for measuring the acting pressure,

an interpreting unit for determining systolic pressure (PSYS) and/or diastolic pressure (PDIAS),

a sensor for simultaneous measurement of the effect of the variable pressure on an artery at a second point, said second point being farther away from the heart, i.e. closer to the end point of peripheral circulation, than the compression point to which the acting pressure is applied, and

estimation means for estimating the quality of an actual blood pressure measurement, and that the estimation means is in connection with the sensor measuring the pressure pulse at the measuring point and feeding the measurement data to the estimation means, the sensor being either the same sensor that is used in the actual blood pressure measurement for measuring the effect of the acting pressure, or a second, different sensor, and that the estimation means further includes a calculation means, adapted to calculate from the measurement data measured by the pressure pulse sensor one or more statistical parameters representing the magnitude of pressure pulse variation for forecasting and/or depicting the quality of the actual blood pressure measurement.

33. A measurement arrangement as claimed in claim 31, characterized in that for estimating the blood pressure measurement, a measurement is performed before or after the actual blood pressure measurement, or both before and after the actual blood pressure measurement.

34. A measurement arrangment as claimed in claim 31, characterized in that the estimation means comprises a reference comparator, arranged to compare the result of the estimation with reference values set for the quality of the actual blood pressure measurement, and that if the estimation result surpasses the reference values set for the quality of the actual blood pressure measurement, the actual blood pressure measurement is initiated, controlled by the reference comparator, or the mesurement result of a performed actual blood pressure measurement is accepted as the final result.

35. A measurement arrangement as claimed in claim 31, characterized in that the estimation means comprises a reference comparator, arranged to compare the result of the estimation with reference values set for the quality of the actual blood pressure measurement, and that if the estimation result is worse than the reference values set for the quality of the actual blood pressure measurement, the actual blood pressure measurement is not initiated or the measurement result of a performed actual blood pressure measurement is rejected.

36. An arrangement as claimed in claim 31, characterized in that the calculation means is arranged to calculate one or more of the following statistical parameters:

magnitude of pressure pulse signal amplitude variation, standard deviation of pressure pulse signal amplitude variation, standard deviation and/or mean of the absolute maximums (ABSMAX) of the pressure pulse signal, standard deviation and/or mean of the absolute minimums (ABSMIN) of the pressure pulse signal, standard deviation and/or mean of the local maximums (LMAX) of the pressure pulse signal, standard deviation and/or mean of the local minimums (LMIN) of the pressure pulse signal.

37. An arrangement as claimed in claim 31, characterized in that the estimation means comprises a trend indicator, arranged to estimate if the blood pressure value shows a trend towards a higher or lower value during estimation or if the trend is essentially indicative of a stable blood pressure value.

38. An arrangement as claimed in claim 31, characterized in that the pressure pulse measuring sensor or the pressure oscillation signal measuring element is a multichannel sensor.

39. An arrangement as claimed in claim 31, characterized by comprising a display for displaying the result of the estimation.

40. An arrangement as claimed in claim 39, characterized in that the display is common both for displaying the result of the estimation of the quality of the actual blood pressure measurement and for displaying the result of the actual blood pressure measurement.

41. An arrangement as claimed in claim 31, characterized in that the arrangement comprises an amplifier and filter for amplifying and filtering the pressure pulse signal measured by the sensor, and and A/D converter for performing A/D conversion after filtering.

42. An arrangement as claimed in claim 31, characterized in that the estimate means is part of a wristband type of unit, which also comprises the pressure pulse measuring sensor for said estimation.

43. An arrangement as claimed in claim 31, characterized in that the estimation means is part of a wristband type or other type of unit, which is in a wireless connection or in a wired connection with said sensor measuring the pressure pulse from the body for the estimation.

44. An arrangement as claimed in claim 31, characterized in that the estimation means is part of the same entity as the interpreting unit.

45. An arrangement as claimed in claim 44, characterized in that the estimation means is part of the interpreting unit.

46. An arrangement as claimed in claim 31, characterized in that the estimation means comprises a means for observing the pressure pulse signal measurement in the estimation cycle (EC) and the pressure pulse signal measurement in the actual blood pressure measurement cycle (MC) as comparable measurements with regard to time, and a determination means for determining the point where the instant of determining the diastolic pressure (PDIAS) in the actual blood pressure measurement is located in relation to upper and lower peaks of a pressure pulse signal variation signal (S) generated on the basis of the estimation cycle measurement (EC).

47. An arrangement as claimed in claim 31, characterized in that the estimation means comprises a means for observing the pressure pulse signal measurement in the estimation cycle (EC) and the pressure pulse signal measurement in the actual blood pressure measurement cycle (MC) as comparable measurements with regard to time, and a determination means for determining the point where the instant of determining the systolic pressure (PSYS) in the actual blood pressure measurement is located in relation to upper and lower peaks of a pressure pulse signal variation signal (S) according to the trend estimated on the basis of the estimation cycle measurement (EC).

48. An arrangement as claimed in claim 31, characterized in that the sensor employed in the actual blood pressure measurement for measuring the effect of the acting pressure at the second point is a sensor which measures the effect of the acting pressure and the pressure pulse generated by heartbeat and is coupled to said interpreting unit, to which a measuring signal indicative of the measurement value of the acting pressure is also coupled, and that said interpreting unit is arranged to determine diastolic pressure (PDIAS) and/or systolic pressure (PSYS) on the basis of a pressure which is acting upon the detection of a change, characteristic of diastolic pressure (PDIAS) and/or systolic pressure (PSYS), in the pressure pulse signal measured by the sensor.

32. An arrangement for blood pressure measurement, comprising:

a pressure generator for applying an acting pressure to a measuring point, such as a person'"'"'s extremity or the like,

a measuring element for measuring the acting pressure and its effect by measuring a pressure oscillation signal of the pressure generator,

an interpreting unit for determining systolic pressure (PSYS) and/or diastolic pressure (PDIAS) oscillometrically from the pressure oscillation signal, and

estimation means for estimating the quality of an actual blood pressure measurement, and that the estimation means is in connection with the measuring element or with a sensor measuring the pressure oscillation signal and feeding the measurement data to the estimation means, and that the estimation means further includes a calculation means, adapted to calculate from the measurement data of the measured pressure oscillation signal one or more statistical parameters representing the magnitude of pressure oscillation signal variation for forecasting and/or depicting the quality of the actual blood pressure measurement.

49. A method for blood pressure measurement, the method comprising applying a variable compressive acting pressure to a measuring point, such as a person'"'"'s extremity or the like, at a compression point by a pressure generator, and at the same time measuring the effect of the variable pressure on the artery at a second point located farther away from the heart, i.e. closer to the end point of peripheral circulation than the compression point to which the pressure is applied, wherein diastolic pressure (PDIAS) and/or systolic pressure (PSYS) is determined as a result of an actual blood pressure measurement,

characterized in that in addition to the actual blood pressure measurement, the method comprises using an estimation cycle for the actual measurement, during which the magnitude of a pressure pulse is measured by a sensor measuring a pressure pulse signal, wherein the pressure pulse is measured in the area of the radial artery, and that one or more statistical parameters are calculated from the pressure pulse measurement data to represent the magnitude of pressure pulse variation for forecasting and/or depicting the quality of the actual blood pressure measurement.

50. A method for blood pressure measurement, the method comprising applying a variable compressive acting pressure to a measuring point, such as a person'"'"'s extremity or the like, at a compression point by a pressure generator, and at the same time measuring the effect of the variable pressure on the artery at a second point located farther away from the heart, i.e. closer to the end point of peripheral circulation than the compression point to which the pressure is applied, wherein diastolic pressure (PDIAS) and/or systolic pressure (PSYS) is determined as a result of an actual blood pressure measurement,

characterized in that in addition to the actual blood pressure measurement, the method comprises using an estimation cycle for the actual measurement, during which the magnitude of a pressure pulse is measured by a sensor measuring a pressure pulse signal, wherein the pressure pulse is measured as a multichannel measurement, and that one or more statistical parameters are calculated from the pressure pulse measurement data to represent the magnitude of pressure pulse variation for forecasting and/or depicting the quality of the actual blood pressure measurement.

51. An arrangement for blood pressure measurement, comprising:

a pressure generator for applying an acting pressure to a measuring point, such as a person'"'"'s extremity or the like,

a measuring element for measuring the acting pressure,

an interpreting unit for determining systolic pressure (PSYS) and/or diastolic pressure (PDIAS),

a sensor for simultaneous measurement of the effect of the variable pressure on an artery at a second point, said second point being farther away from the heart, i.e. closer to the end point of peripheral circulation, than the compression point to which the acting pressure is applied, wherein said sensor is a multichannel sensor,

an estimation means for estimating the quality of an actual blood pressure measurement, and that the estimation means is in connection with the sensor measuring the pressure pulse at the measuring point and feeding the measurement data to the estimation means, the sensor being either the same sensor that is used in the actual blood pressure measurement for measuring the effect of the acting pressure, or a second, different sensor, and that the estimation means further includes a calculation means, adapted to calculate from the measurement data measured by said sensor one or more statistical parameters representing the magnitude of pressure pulse variation for forecasting and/or depicting the quality of the actual blood pressure measurement.

52. An arrangement for blood pressure measurement, comprising:

a pressure generator for applying an acting pressure to a measuring point, such as a person'"'"'s extremity or the like,

a measuring element for measuring the acting pressure,

an interpreting unit for determining systolic pressure (PSYS) and/or diastolic pressure (PDIAS),

a sensor for simultaneous measurement of the effect of the variable pressure on an artery at a second point, said second point being farther away from the heart, i.e. closer to the end point of peripheral circulation, than the compression point to which the acting pressure is applied,

an estimation means for estimating the quality of an actual blood pressure measurement, and that the estimation means is in connection with the sensor measuring the pressure pulse at the measuring point and feeding the measurement data to the estimation means, the sensor being either the same sensor that is used in the actual blood pressure measurement for measuring the effect of the acting pressure, or a second, different sensor, and that the estimation means further includes a calculation means, adapted to calculate from the measurement data measured by said sensor one or more statistical parameters representing the magnitude of pressure pulse variation for forecasting and/or depicting the quality of the actual blood pressure measurement, and said estimation means is part of a wrist band type of unit, which also includes said sensor for said estimation.

53. An arrangement for blood pressure measurement, comprising:

a pressure generator for applying an acting pressure to a measuring point, such as a person'"'"'s extremity or the like,

a measuring element for measuring the acting pressure,

an interpreting unit for determining systolic pressure (PSYS) and/or diastolic pressure (PDIAS),

a sensor for simultaneous measurement of the effect of the variable pressure on an artery at a second point, said second point being farther away from the heart, i.e. closer to the end point of peripheral circulation, than the compression point to which the acting pressure is applied,

an estimation means for estimating the quality of an actual blood pressure measurement, and that the estimation means is in connection with the sensor measuring the pressure pulse at the measuring point and feeding the measurement data to the estimation means, the sensor being either the same sensor that is used in the actual blood pressure measurement for measuring the effect of the acting pressure, or a second, different sensor, and that the estimation means further includes a calculation means, adapted to calculate from the measurement data measured by said sensor one or more statistical parameters representing the magnitude of pressure pulse variation for forecasting and/or depicting the quality of the actual blood pressure measurement, and said estimation means is part of a wrist band type or other type of unit, which is in a wireless connection or in a wired connection with said sensor measuring the pressure pulse from the body for the estimation.