Hypertension is a leading cause of morbidity and mortality worldwide. The ability to diagnose and treat hypertension in the ambulatory population is hindered by limited access and poor adherence to current methods of monitoring blood pressure (BP), specifically, cuff-based devices. Remote photoplethysmography (rPPG) evaluates an individual's pulse waveform through a standard camera without physical contact. Cameras are readily available to the majority of the global population via embedded technologies such as smartphones, thus rPPG is a scalable and promising non-invasive method of BP monitoring. The few studies investigating rPPG for BP measurement have excluded high-risk populations, including those with cardiovascular disease (CVD) or its risk factors, as well as subjects in active cardiac arrhythmia. The impact of arrhythmia, like atrial fibrillation, on the prediction of BP using rPPG is currently uncertain. We performed a study to better understand the relationship between rPPG and BP in a real-world sample of ambulatory patients from a cardiology clinic with established CVD or risk factors for CVD. We collected simultaneous rPPG, PPG, BP, ECG, and other vital signs data from 143 subjects while at rest, and used this data plus demographics to train a deep learning model to predict BP. We report that facial rPPG yields a signal that is comparable to finger PPG. Pulse wave analysis (PWA)-based BP estimates on this cohort performed comparably to studies on healthier subjects, and notably, the accuracy of BP prediction in subjects with atrial fibrillation was not inferior to subjects with normal sinus rhythm. In a binary classification task, the rPPG model identified subjects with systolic BP $\geq$ 130 mm Hg with a positive predictive value of 71% (baseline prevalence 48.3%), highlighting the potential of rPPG for hypertension monitoring.

Blood pressure (BP) is a key indicator of cardiovascular health. As hypertension remains a global cause of morbidity and mortality, accurate, continuous, and non-invasive BP monitoring is therefore of paramount importance. Photoplethysmography (PPG) and electrocardiography (ECG) can potentially enable continuous BP monitoring, yet training accurate and robust machine learning (ML) models remains challenging due to variability in data quality and patient-specific factors. Recently, multiple research groups explored Electroencephalographic (EEG)--based foundation models and demonstrated their exceptional ability to learn rich temporal resolution. Considering the morphological similarities between different biosignals, the question arises of whether a model pre-trained on one modality can effectively be exploited to improve the accuracy of a different signal type. In this work, we take an initial step towards generalized biosignal foundation models by investigating whether model representations learned from abundant EEG data can effectively be transferred to ECG/PPG data solely with fine-tuning, without the need for large-scale additional pre-training, for the BP estimation task. Evaluations on the MIMIC-III and VitalDB datasets demonstrate that our approach achieves near state-of-the-art accuracy for diastolic BP (mean absolute error of 1.57 mmHg) and surpasses by 1.5x the accuracy of prior works for systolic BP (mean absolute error 2.72 mmHg). Additionally, we perform dynamic INT8 quantization, reducing the smallest model size by over 3.5x (from 13.73 MB down to 3.83 MB) while preserving performance, thereby enabling unobtrusive, real-time BP monitoring on resource-constrained wearable devices.

Time series data mining is immensely important in extensive applications, such as traffic, medical, and e-commerce. In this paper, we focus on medical temporal variation modeling, \emph{i.e.,} cuffless blood pressure (BP) monitoring which has great value in cardiovascular healthcare. Although providing a comfortable user experience, such methods are suffering from the demand for a significant amount of realistic data to train an individual model for each subject, especially considering the invasive or obtrusive BP ground-truth measurements. To tackle this challenge, we introduce a novel physics-informed temporal network~(PITN) with adversarial contrastive learning to enable precise BP estimation with very limited data. Specifically, we first enhance the physics-informed neural network~(PINN) with the temporal block for investigating BP dynamics' multi-periodicity for personal cardiovascular cycle modeling and temporal variation. We then employ adversarial training to generate extra physiological time series data, improving PITN's robustness in the face of sparse subject-specific training data. Furthermore, we utilize contrastive learning to capture the discriminative variations of cardiovascular physiologic phenomena. This approach aggregates physiological signals with similar blood pressure values in latent space while separating clusters of samples with dissimilar blood pressure values. Experiments on three widely-adopted datasets with different modailties (\emph{i.e.,} bioimpedance, PPG, millimeter-wave) demonstrate the superiority and effectiveness of the proposed methods over previous state-of-the-art approaches. The code is available at~\url{https://github.com/Zest86/ACL-PITN}.

Large language models (LLMs) have captured significant interest from both academia and industry due to their impressive performance across various textual tasks. However, the potential of LLMs to analyze physiological time-series data remains an emerging research field. Particularly, there is a notable gap in the utilization of LLMs for analyzing wearable biosignals to achieve cuffless blood pressure (BP) measurement, which is critical for the management of cardiovascular diseases. This paper presents the first work to explore the capacity of LLMs to perform cuffless BP estimation based on wearable biosignals. We extracted physiological features from electrocardiogram (ECG) and photoplethysmogram (PPG) signals and designed context-enhanced prompts by combining these features with BP domain knowledge and user information. Subsequently, we adapted LLMs to BP estimation tasks through fine-tuning. To evaluate the proposed approach, we conducted assessments of ten advanced LLMs using a comprehensive public dataset of wearable biosignals from 1,272 participants. The experimental results demonstrate that the optimally fine-tuned LLM significantly surpasses conventional task-specific baselines, achieving an estimation error of 0.00 $\pm$ 9.25 mmHg for systolic BP and 1.29 $\pm$ 6.37 mmHg for diastolic BP. Notably, the ablation studies highlight the benefits of our context enhancement strategy, leading to an 8.9% reduction in mean absolute error for systolic BP estimation. This paper pioneers the exploration of LLMs for cuffless BP measurement, providing a potential solution to enhance the accuracy of cuffless BP measurement.

Recent statistics indicate that approximately 1.3 billion individuals worldwide suffer from hypertension, a leading cause of premature death globally. Blood pressure (BP) serves as a critical health indicator for accurate and timely diagnosis and/or treatment of hypertension. Driven by recent advancements in Artificial Intelligence (AI) and Deep Neural Networks (DNNs), there has been a surge of interest in developing data-driven and cuff-less BP estimation solutions. In this context, current literature predominantly focuses on coupling Electrocardiography (ECG) and Photoplethysmography (PPG) sensors, though this approach is constrained by reliance on multiple sensor types. An alternative, utilizing standalone PPG signals, presents challenges due to the absence of auxiliary sensors (ECG), requiring the use of morphological features while addressing motion artifacts and high-frequency noise. To address these issues, the paper introduces the TransfoRhythm framework, a Transformer-based DNN architecture built upon the recently released physiological database, MIMIC-IV. Leveraging Multi-Head Attention (MHA) mechanism, TransfoRhythm identifies dependencies and similarities across data segments, forming a robust framework for cuff-less BP estimation solely using PPG signals. To our knowledge, this paper represents the first study to apply the MIMIC IV dataset for cuff-less BP estimation, and TransfoRhythm is the first MHA-based model trained via MIMIC IV for BP prediction. Performance evaluation through comprehensive experiments demonstrates TransfoRhythm's superiority over its state-of-the-art counterparts. Specifically, TransfoRhythm achieves highly accurate results with Root Mean Square Error (RMSE) of [1.84, 1.42] and Mean Absolute Error (MAE) of [1.50, 1.17] for systolic and diastolic blood pressures, respectively.

Hypertension, a leading contributor to cardiovascular morbidity, underscores the need for accurate and continuous blood pressure (BP) monitoring. Photoplethysmography (PPG) presents a promising approach to this end. However, the precision of BP estimates derived from PPG signals has been the subject of ongoing debate, necessitating a comprehensive evaluation of their effectiveness and constraints. We developed a calibration-based Siamese ResNet model for BP estimation, using a signal input paired with a reference BP reading. We compared the use of normalized PPG (N-PPG) against the normalized Invasive Arterial Blood Pressure (N-IABP) signals as input. The N-IABP signals do not directly present systolic and diastolic values but theoretically provide a more accurate BP measure than PPG signals since it is a direct pressure sensor inside the body. Our strategy establishes a critical benchmark for PPG performance, realistically calibrating expectations for PPG's BP estimation capabilities. Nonetheless, we compared the performance of our models using different signal-filtering conditions to evaluate the impact of filtering on the results. We evaluated our method using the AAMI and the BHS standards employing the VitalDB dataset. The N-IABP signals meet with AAMI standards for both Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP), with errors of 1.29+-6.33mmHg for systolic pressure and 1.17+-5.78mmHg for systolic and diastolic pressure respectively for the raw N-IABP signal. In contrast, N-PPG signals, in their best setup, exhibited inferior performance than N-IABP, presenting 1.49+-11.82mmHg and 0.89+-7.27mmHg for systolic and diastolic pressure respectively. Our findings highlight the potential and limitations of employing PPG for BP estimation, showing that these signals contain information correlated to BP but may not be sufficient for predicting it accurately.

Commented [ZS1]: Add ORCIDs to all authors that have them. Abstract Blood Pressure (BP) estimation plays a pivotal role in diagnosing various health conditions, highlighting the need for innovative approaches to overcome conventional measurement challenges. Leveraging machine learning and speech signals, this study investigates accurate BP estimation with a focus on preprocessing, feature extraction, and real-time applications. An advanced clusteringbased strategy, incorporating the k-means algorithm and the proposed Fact-Finding Instructor optimization algorithm, is introduced to enhance accuracy. The combined outcome of these clustering techniques enables robust BP estimation. Moreover, extending beyond these insights, this study delves into the dynamic realm of contemporary digital content consumption. Platforms like YouTube have emerged as influential spaces, presenting an array of videos that evoke diverse emotions. Within this context, this research investigates the interplay between YouTube videos and physiological responses, particularly Blood Pressure (BP) levels. By integrating advanced BP estimation techniques with the emotional dimensions of YouTube videos, this study enriches our understanding of how modern media environments intersect with health implications. Performance evaluation through metrics including Davies Bouldin score, Homogeneity, completeness, Jacquard similarity, Silhouette score, and Dunn's index demonstrates substantial enhancements, particularly with a 90% training percentage. This method offers promising potential for accurate BP estimation, contributing to the evolution of assessment methodologies and ultimately enhancing healthcare outcomes. Introduction: According to Kaur et al. (2019) a human disease is a particular aberrant state that has a detrimental effect on an organism's overall structure or function but is not instantly caused by an external injury. According to Gautam et al.(2019) there are four main groups of diseases that affect humans: infectious diseases, deficiency disorders, hereditary diseases, and physiological diseases.

Accurate and continuous blood pressure (BP) monitoring is essential to the early prevention of cardiovascular diseases. Non-invasive and cuff-less BP estimation algorithm has gained much attention in recent years. Previous studies have demonstrated that brain bio-impedance (BIOZ) is a promising technique for non-invasive intracranial pressure (ICP) monitoring. Clinically, treatment for patients with traumatic brain injuries (TBI) requires monitoring the ICP and BP of patients simultaneously. Estimating BP by brain BIOZ directly can reduce the number of sensors attached to the patients, thus improving their comfort. To address the issues, in this study, we explore the feasibility of leveraging brain BIOZ for BP estimation and propose a novel cuff-less BP estimation approach called BrainZ-BP. Two electrodes are placed on the forehead and occipital bone of the head in the anterior-posterior direction for brain BIOZ measurement. Various features including pulse transit time and morphological features of brain BIOZ are extracted and fed into four regression models for BP estimation. Results show that the mean absolute error, root mean square error, and correlation coefficient of random forest regression model are 2.17 mmHg, 3.91 mmHg, and 0.90 for systolic pressure estimation, and are 1.71 mmHg, 3.02 mmHg, and 0.89 for diastolic pressure estimation. The presented BrainZ-BP can be applied in the brain BIOZ-based ICP monitoring scenario to monitor BP simultaneously.