A Smart Ring for Cuffless Blood Pressure to Reduce Health Disparities in People of Color

用于无袖血压测量的智能环，可减少有色人种的健康差异

• 批准号: 10720348
• 负责人: Roozbeh Jafari
• 金额: $ 59.73万
• 依托单位: TEXAS ENGINEERING EXPERIMENT STATION
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-07-15 至 2027-04-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10720348
• 关键词: Address; Affect; African American; African American population; Age; Ambulatory Blood Pressure Monitoring; Antihypertensive Agents; Artificial Intelligence; Atherosclerosis; Blood Pressure; Blood Pressure Monitors; Blood Volume; Body mass index; Calibration; Cardiovascular Diseases; Cardiovascular system; Characteristics; Clinical Research; Color; Communities; Data; Detection; Development; Devices; Early Diagnosis; Effectiveness; Exercise; Fatty acid glycerol esters; Fingers; High Prevalence; Hospitals; Human; Hypertension; Imaging technology; Industrialization; Intervention Studies; Investigation; Latinx; Legal patent; Light; Literature; Machine Learning; Masks; Measurement; Measures; Melanins; Methods; Modality; Modeling; Monitor; Not Hispanic or Latino; Obesity; Optics; Organ; Participant; Patient Self-Report; Patients; Pattern; Penetration; Pharmaceutical Preparations; Photoplethysmography; Physicians; Physiologic pulse; Positioning Attribute; Posture; Prevalence; Pulse Pressure; Recording of previous events; Reduce health disparities; Regimen; Reporting; Research; Risk Factors; Science; Signal Transduction; Skin; Sleep; Subgroup; Supination; Supine Position; System; Technology; Texas; Time; Tissues; Translating; Validation; Variant; Weight; Work; adverse outcome; artificial intelligence algorithm; attenuation; blood pressure elevation; cardiovascular risk factor; clinical decision support; cohort; college; design; experience; health equity; hemodynamics; high body mass index; hypertensive; indexing; insight; masked hypertension; monitoring device; multidisciplinary; novel; outcome disparities; patient subsets; people of color; prevent; recruit; response; sensor; sex; skin color; smart watch; social; technology development; technology validation; trend; wearable device; wearable sensor technology; Address; Affect; African American; African American population; Age; Ambulatory Blood Pressure Monitoring; Antihypertensive Agents; Artificial Intelligence; Atherosclerosis; Blood Pressure; Blood Pressure Monitors; Blood Volume; Body mass index; Calibration; Cardiovascular Diseases; Cardiovascular system; Characteristics; Clinical Research; Color; Communities; Data; Detection; Development; Devices; Early Diagnosis; Effectiveness; Exercise; Fatty acid glycerol esters; Fingers; High Prevalence; Hospitals; Human; Hypertension; Imaging technology; Industrialization; Intervention Studies; Investigation; Latinx; Legal patent; Light; Literature; Machine Learning; Masks; Measurement; Measures; Melanins; Methods; Modality; Modeling; Monitor; Not Hispanic or Latino; Obesity; Optics; Organ; Participant; Patient Self-Report; Patients; Pattern; Penetration; Pharmaceutical Preparations; Photoplethysmography; Physicians; Physiologic pulse; Positioning Attribute; Posture; Prevalence; Pulse Pressure; Recording of previous events; Reduce health disparities; Regimen; Reporting; Research; Risk Factors; Science; Signal Transduction; Skin; Sleep; Subgroup; Supination; Supine Position; System; Technology; Texas; Time; Tissues; Translating; Validation; Variant; Weight; Work; adverse outcome; artificial intelligence algorithm; attenuation; blood pressure elevation; cardiovascular risk factor; clinical decision support; cohort; college; design; experience; health equity; hemodynamics; high body mass index; hypertensive; indexing; insight; masked hypertension; monitoring device; multidisciplinary; novel; outcome disparities; patient subsets; people of color; prevent; recruit; response; sensor; sex; skin color; smart watch; social; technology development; technology validation; trend; wearable device; wearable sensor technology

PROJECT SUMMARY/ABSTRACT Hypertension is the most prevalent cardiovascular risk factor and disproportionately responsible for adverse outcomes in African Americans. African Americans with hypertension are also more likely to be unaware of elevated blood pressures, which further exacerbates complications of cardiovascular disease. Thus, detection of accurate blood pressure in African Americans is a critical step towards alleviating hypertension disparate outcomes. The objective of this project is to create an unobtrusive cuffless blood pressure monitor for measurement and identification for masked hypertension in communities of color. Current state of the technology that incorporates cuffs is cumbersome and does not allow for passive/frequent measurements. The trends for cuffless solutions are primarily focused on photoplethysmography (PPG) which does not operate well on darker skin tones and on participants with higher BMIs. This project leverages bioimpedance as a sensing modality in the form of a finger-worn device, like smart rings. Our device provides robust and nearly continuous bioimpedance readings, corresponding to blood volume and hemodynamic changes, that will be translated to blood pressure using machine learning and AI algorithms. Bioimpedance does not have the limitations of PPG; it is insensitive to varying skin tones and has deep penetration capabilities and therefore a higher BMI (and a thicker layer of fat under the skin) does not impact the measurements. The principal focus of our investigation is to gain insights into masked hypertension with the objective of capturing blood pressure frequently during the day and at nighttime. Our proposed technology can help identify certain short-term dynamics inclusive of variations of blood pressure and allows effective monitoring of response to medication for African American in Atlanta, GA and African American and Latinx communities in College Station, TX. This project incorporates two aims. Aim 1 intends to validate the smart ring technology that has been developed at Texas A&M on African American and Latinx participants (N=60) with varying BMI in lab settings, with no known pre-existing condition beyond obesity, in presence of various blood pressure maneuvers (cold pressor, handgrip and exercise) and for three postures (supine, standing and sitting). Aim 2 expands the validation of our technology in African American patients (N=144) with and without a history of hypertension in Atlanta, GA in mixed lab and ambulatory settings with a unique focus to explore the reported phenomenon of masked hypertension and to advance technology acceptance and social relevance in communities of color. After nearly ten years of industrial and academic technology development to extract blood pressure indices using PPG, to our knowledge, this effort for the first time addresses the limited effectiveness of PPG on darker skin tones and those who have a higher BMI. The literature demonstrates the higher prevalence of hypertension in African American communities and among those who have obesity, which further calls for BMI independent technology development and validation.

项目摘要/摘要 高血压是最普遍的心血管危险因素，不成比例地负责不利 非裔美国人的结果。患有高血压的非裔美国人也更有可能不知道 血压升高，进一步加剧了心血管疾病的并发症。因此，检测 非洲裔美国人的准确血压是减轻高血压不同的关键一步 结果。该项目的目的是为为 在有色社区中掩盖高血压的测量和鉴定。当前状态 结合袖口的技术很麻烦，不允许进行被动/频繁的测量。这 无袖口解决方案的趋势主要集中于未运行 在较深的肤色和BMI的参与者上都很好。该项目利用生物阻抗为 以智能环的形式感测的方式，如智能戒指。我们的设备提供了强大的功能 连续的生物阻抗读数，对应于血容量和血液动力学变化，这将是 使用机器学习和AI算法转化为血压。生物阻抗没有 PPG的局限性；它对变化的肤色不敏感，具有深厚的穿透能力，因此 较高的BMI（皮肤下的脂肪层较厚）不会影响测量值。主要重点 我们的调查是为了捕获血压的目的而获得对蒙面高血压的见解 经常在白天和夜间。我们提出的技术可以帮助确定某些短期 包括血压变化的动力学，并有效监测对药物的反应 在佐治亚州亚特兰大的非裔美国人以及德克萨斯州大学站的非裔美国人和拉丁裔社区。这 项目结合了两个目标。目标1打算验证已开发的智能环技术 在非洲裔美国人和拉丁裔参与者（n = 60）的德克萨斯A＆M，在实验室设置中有不同的BMI，没有 在存在各种血压操纵的情况下，已知的肥胖症以外的已知现有状况（冷persor， 手夹和运动）和三个姿势（仰卧，站立和坐着）。 AIM 2扩展了验证 我们在非裔美国人患者中的技术（n = 144），有和没有高血压史 在混合实验室和门诊环境中，亚特兰大，乔治亚州，具有独特的重点，以探索报道的现象 掩盖高血压，并在有色社区中提高技术接受和社会相关性。 经过将近十年的工业和学术技术发展，提取血压指数 据我们所知，使用PPG首次解决了PPG对黑暗的有限效力 肤色和较高BMI的人。文献证明了更高的流行率 非裔美国人社区以及肥胖症的人中的高血压，进一步要求BMI 独立的技术开发和验证。