Accurate blood pressure measurement
Lead Research Organisation:
Newcastle University
Department Name: Sch of Engineering
Abstract
The current clinical problem: raised arterial blood pressure (hypertension) is the third leading cause of death worldwide. Cardiovascular disease causes 17 million deaths per annum globally with complications arising from high blood pressure accounting for 9.4 million, split evenly between stroke and heart disease (World Health Organization, Global Status Report on non-communicable diseases 2014, "Attaining the nine global non-communicable diseases targets; a shared responsibility"). The WHO reported that 'Cardiovascular disease causes more than half of all deaths across the European Region'. The first important step in correctly diagnosing hypertension is in the accurate measurement of blood pressure (BP). This research project will result in an effective diagnostic device that will have the potential to displace all current devices on the market.
There is a worldwide need for accurate blood pressure measurement. The "gold standard" is the manual method, with an experienced clinician listening to the stethoscope Korotkoff sounds and viewing a cuff pressure scale. However, this is increasingly being underused because of the training needed and the time required for the measurement in busy clinics, and is almost never used for self measurement at home. The current undesirable move to replace manual by automated devices (they all unfortunately use the oscillometric technique) can result in radically different measurements on the same patient for different devices. Inaccurate measurement is such a problem that the UK Department of Health has had to issue several Warning Notices about current automated devices.
The aim of our research is to develop a novel technique for accurately and automatically measuring blood pressure. Our previous EPSRC research made observations that are now the basis of this proposed research, and were sufficiently novel to enable a patent application.
Working with our Industrial Partner will enable this research development to be taken to a marketable product available for hospital or home use.
The ultimate benefit will be for patients and clinicians who will be able to diagnose high blood pressure and monitor treatment more effectively than now. Since the technology is a radically new departure it will open up avenues for academic research in engineering and clinical medicine.
There is a worldwide need for accurate blood pressure measurement. The "gold standard" is the manual method, with an experienced clinician listening to the stethoscope Korotkoff sounds and viewing a cuff pressure scale. However, this is increasingly being underused because of the training needed and the time required for the measurement in busy clinics, and is almost never used for self measurement at home. The current undesirable move to replace manual by automated devices (they all unfortunately use the oscillometric technique) can result in radically different measurements on the same patient for different devices. Inaccurate measurement is such a problem that the UK Department of Health has had to issue several Warning Notices about current automated devices.
The aim of our research is to develop a novel technique for accurately and automatically measuring blood pressure. Our previous EPSRC research made observations that are now the basis of this proposed research, and were sufficiently novel to enable a patent application.
Working with our Industrial Partner will enable this research development to be taken to a marketable product available for hospital or home use.
The ultimate benefit will be for patients and clinicians who will be able to diagnose high blood pressure and monitor treatment more effectively than now. Since the technology is a radically new departure it will open up avenues for academic research in engineering and clinical medicine.
Planned Impact
The most important impact will be for patients who suffer from high blood pressure, who stand to have their blood pressure better monitored, and be given more appropriate treatment. It will stimulate further the use of home monitoring devices, which with reliable and stable measurements will encourage patients to change their lifestyle to reduce their blood pressure. Reliable measurements will be welcomed by clinical and nursing staff, who will have better monitoring, and better confidence in the treatment selected. It will enable automated measurements to be made with confidence, freeing up some time during medical consultations. Overall this should lead to improved public health.
There will be an impact on how new drugs are evaluated, simplifying the clinical trials, and potentially bringing new drugs to the market quicker.
The greatest financial impact will be with manufacturers of medical devices that manufacture blood pressure devices, who may need to make significant changes in their production.
impact will be made on international standards, and the testing and validation of these devices will need to change.
There will be an impact on how new drugs are evaluated, simplifying the clinical trials, and potentially bringing new drugs to the market quicker.
The greatest financial impact will be with manufacturers of medical devices that manufacture blood pressure devices, who may need to make significant changes in their production.
impact will be made on international standards, and the testing and validation of these devices will need to change.
Publications
Liu C
(2016)
Comparison of stethoscope bell and diaphragm, and of stethoscope tube length, for clinical blood pressure measurement.
in Blood pressure monitoring
Mieke S
(2023)
Technical evaluation of a simulator for accurate reproduction of oscillometric blood pressure pulses, providing traceability for automated oscillometric sphygmomanometers.
in Biomedical physics & engineering express
Murray A
(2018)
Study of Blood Pressure During Controlled Respiration
Murray A.
(2019)
Variability in Blood Pressure Measurements from Recorded Auscultation Sounds
in Computing in Cardiology
Pan F
(2017)
Variation of the Korotkoff Stethoscope Sounds During Blood Pressure Measurement: Analysis Using a Convolutional Neural Network.
in IEEE journal of biomedical and health informatics
Sharman JE
(2023)
Automated 'oscillometric' blood pressure measuring devices: how they work and what they measure.
in Journal of human hypertension
Stergiou GS
(2020)
STRIDE BP: an international initiative for accurate blood pressure measurement.
in Journal of hypertension
Description | Characteristic features of the cuff pressure during manual or automated blood pressure measurement have been identified, and they have potential for significant improvements in the accuracy of blood pressure measurement. |
Exploitation Route | They should improve clinical blood pressure measurement. |
Sectors | Healthcare |
Description | The patent to protect the intellectual property has been published, and now has been awarded. The main commercial medical device manufacturers have been contacted, and the research technique demonstrated. Some manufacturers have shown interest, and we have received funding for expanding the patent rights. Prototype development of features suitable for commercial development is ongoing. |
First Year Of Impact | 2017 |
Sector | Healthcare |
Impact Types | Societal |
Description | Healthcare Impact Partnership |
Amount | £370,000 (GBP) |
Organisation | Engineering and Physical Sciences Research Council (EPSRC) |
Sector | Public |
Country | United Kingdom |
Start | 07/2016 |
End | 07/2019 |
Description | Academic collaborator: Dr John Amoore |
Organisation | Crosshouse Hospital |
Country | United Kingdom |
Sector | Hospitals |
PI Contribution | Dr John Amoore provide advice on commercial automatic blood pressure devices. |
Collaborator Contribution | Advice and publications |
Impact | Publication in Computing in Cardiology |
Start Year | 2008 |
Description | Academic collaborator: Dr Stephan Mieke |
Organisation | Physikalisch-Technische Bundesanstalt |
Country | Germany |
Sector | Academic/University |
PI Contribution | Dr Stephan Mieke collaborated with the blood pressure simulator. We also worked closely with him in the International Standards bodies to use the insights gained to develop the current international standards. |
Collaborator Contribution | Work on international standards |
Impact | Publication in Computing in Cardiology |
Start Year | 2008 |
Description | Commercial Partner: Mr Adrian Cossor |
Organisation | AC Cossor & Son (Surgical) |
Country | United Kingdom |
Sector | Private |
PI Contribution | Support of Mr Adrian Cossor, managing director of AC Cossor and manufacturer of the Accoson range of blood pressure devices, the only such devices manufactured in the UK. We have worked together over the Accoson electronic greenlight device, in which he invested significantly and which is returning royalties to Newcastle University and Newcastle NHS Trust. Mr Cossor contributed very positively for this project. |
Collaborator Contribution | Assistance with cuffs, and clinical measurement advice As part funder he is dealing with licensing of device for manufacture, but since our contact with Newcastle University Business moved to a new appointment, progress has been very slow. |
Impact | Continuing collaboration |
Start Year | 2008 |
Title | AN IMPROVED BLOOD PRESSURE MEASUREMENT SYSTEM |
Description | New blood pressure measurement technique |
IP Reference | PCT/GB2016/051065 |
Protection | Patent / Patent application |
Year Protection Granted | |
Licensed | Commercial In Confidence |
Impact | Independent assessment of accuracy |
Title | Medical device |
Description | Patent submitted, and in discussion with manufacturers |
Type | Diagnostic Tool - Non-Imaging |
Current Stage Of Development | Refinement. Clinical |
Year Development Stage Completed | 2018 |
Development Status | Actively seeking support |
Impact | Better diagnosis |
Description | Standards |
Form Of Engagement Activity | A formal working group, expert panel or dialogue |
Part Of Official Scheme? | No |
Geographic Reach | International |
Primary Audience | Industry/Business |
Results and Impact | To develop and improve international standards |
Year(s) Of Engagement Activity | 2012,2013,2014,2015,2016,2017,2018,2019 |