The Recent Advancements to Measure the Blood Pressure Using Photoplethysmography, Electrocardiogram, and Microchannel

Hajar Danesh , Hamidreza Shirzadfar , Mahla Manian , Melika Pazhom

Smart Wearable Technology ›› 2026, Vol. 2 ›› Issue (1) : 52026420

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Smart Wearable Technology ›› 2026, Vol. 2 ›› Issue (1) :52026420 DOI: 10.47852/bonviewSWT52026420
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The Recent Advancements to Measure the Blood Pressure Using Photoplethysmography, Electrocardiogram, and Microchannel
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Abstract

Uncontrolled blood pressure poses significant health risks, making accurate measurement essential in healthcare. Conventional blood pressure measurement methods, typically using inflatable cuffs, can cause patient discomfort, tissue damage, and are unsuitable for long-term monitoring. Consequently, researchers are exploring noninvasive, cuffless methods that provide continuous and accurate blood pressure assessment. This article presents a comprehensive review of sensors and estimation models used in cuffless blood pressure monitors, with a focus on enhancing accuracy and minimizing calibration requirements. A literature search was conducted using Google Scholar and reputable journals, including IEEE, Frontiers, and MDPI, resulting in the selection of 35 relevant studies. The review examines innovative techniques based on electrical, mechanical, and optical sensors. Particular attention is given to photoplethysmography (PPG), electrocardiography (ECG), and bioimpedance (Bio-Z), which, when combined with advanced signal analysis and deep learning models, show promising results. PPG enables blood volume measurement at accessible sites like the fingertip or wrist, leveraging parameters such as pulse transit time. ECG, which directly reflects heart activity, is also widely used for blood pressure estimation. Recent advancements in machine learning have improved accuracy, with models such as HGCTNet (a hybrid CNN-Transformer architecture) achieving an error margin of 0.9 ± 6.5 mmHg for diastolic and 0.7 ± 8.3 mmHg for systolic blood pressures. Despite the potential, challenges remain, including the need for continuous calibration of PPG-based systems. Ongoing research aims to address these limitations by improving signal quality and developing robust algorithms. The demonstrated accuracy and reduced calibration requirements suggest that cuffless blood pressure monitoring technologies may soon become viable for widespread clinical and home use.

Keywords

blood pressure / medical sensor / monitoring / machine learning / PPG

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Hajar Danesh, Hamidreza Shirzadfar, Mahla Manian, Melika Pazhom. The Recent Advancements to Measure the Blood Pressure Using Photoplethysmography, Electrocardiogram, and Microchannel. Smart Wearable Technology, 2026, 2 (1) : 52026420 DOI:10.47852/bonviewSWT52026420

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References

[1]

Ventura, H. O., & Lavie, C. J. (2018). Hypertension: Management and measurements. Current Opinion in Cardiology, 33(4), 375-376. https://doi.org/10.1097/HCO.0000000000000534

[2]

Dai, D., Ji, Z., & Wang, H. (2024). Non—invasive continuous blood pressure estimation from single—channel PPG based on a temporal convolutional network integrated with an attention mechanism. Applied Sciences, 14(14), 6061. https://doi.org/10.3390/app14146061

[3]

Horne, C. E., Stayt, L. C., Schutz, S., Smith, C. M., Haberstroh, A., Bolin, L. P., ..., & Bibbey, A. (2023). Symptom experiences in hypertension: a mixed methods systematic review. Journal of Hypertension, 41(1), 1-16. https://doi.org/10.1097/hjh.0000000000003306

[4]

Wang, A., Tian, X., Zuo, Y., Chen, S., Zhang, Y., Zhang, X., ..., & Zhou, Y. (2022). Control of blood pressure and risk of cardiovascular disease and mortality in elderly Chinese: A real—world prospective cohort study. Hypertension, 79(8), 1866-1875. https://doi.org/10.1161/HYPERTENSIONAHA.122.19587

[5]

Noh, S. A., Kim, H.—S., Kang, S.—H., Yoon, C.—H., Youn, T.—J., & Chae, I.—H. (2024). History and evolution of blood pressure measurement. Clinical Hypertension, 30(1), 9. https://doi.org/10.1186/s40885-024-00268-7

[6]

Al—Qatatsheh, A., Morsi, Y., Zavabeti, A., Zolfagharian, A., Salim, N., Z. Kouzani, A., ..., & Gharaie, S. (2020). Blood pressure sensors: Materials, fabrication methods, performance evaluations and future perspectives. Sensors, 20(16), 4484. https://doi.org/10.3390/s20164484

[7]

Pickering, T. G., Hall, J. E., Appel, L. J., Falkner, B. E., Graves, J., Hill, M. N., ..., & Roccella, E. J. (2005). Recommendations for blood pressure measurement in humans and experimental animals: Part 1: Blood pressure measurement in humans: A statement for professionals from the subcommittee of professional and public education of the american heart association council on high blood pressure research. Circulation, 111(5), 697-716. https://doi.org/10.1161/01.CIR.0000154900.76284.F6

[8]

Shirzadfar, H., Mokhtari, N., & Claudel, J. (2018). Optimize the geometrical parameters of interdigital micro—electrodes used in bioimpedance sensing system. Journal of Nano— and Electronic Physics, 10(5), 05029. https://doi.org/10.21272/jnep.10(5).05029

[9]

Nishan, A., Raju, S. T. U., Hossain, M. I., Dipto, S. A., Uddin, S. T., Sijan, A., ..., & Khan, M. M. H. (2024). A continuous cuffless blood pressure measurement from optimal PPG characteristic features using machine learning algorithms. Heliyon, 10(6), e27779. https://doi.org/10.1016/j.heliyon.2024.e27779

[10]

Fortino, G., & Giampa, V. (2010). PPG—based methods for non invasive and continuous blood pressure measurement: An overview and development issues in body sensor networks. In 2010 IEEE International Workshop on Medical Measurements and Applications, 10-13. https://doi.org/10.1109/MEMEA.2010.5480201

[11]

Miao, F., Wen, B., Hu, Z., Fortino, G., Wang, X.—P., Liu, Z.—D., ..., & Li, Y. (2020). Continuous blood pressure measurement from one—channel electrocardiogram signal using deep—learning techniques. Artificial Intelligence in Medicine, 108, 101919. https://doi.org/10.1016/j.artmed.2020.101919

[12]

Bird, K., Chan, G., Lu, H., Greeff, H., Allen, J., Abbott, D., ..., & Elgendi, M. (2020). Assessment of hypertension using clinical electrocardiogram features: A first—ever review. Frontiers in Medicine, 7, 583331. https://doi.org/10.3389/fmed.2020.583331

[13]

Mousavi, S. S., Firouzmand, M., Charmi, M., Hemmati, M., Moghadam, M., & Ghorbani, Y. (2019). Blood pressure estimation from appropriate and inappropriate PPG signals using a whole—based method. Biomedical Signal Processing and Control, 47, 196-206. https://doi.org/10.1016/j.bspc.2018.08.022

[14]

Hua, J., Su, M., Wu, J., Zhou, Y., Guo, Y., Shi, Y., & Pan, L. (2024). Wearable cuffless blood pressure monitoring: From flexible electronics to machine learning. Wearable Electronics, 1, 78-90. https://doi.org/10.1016/j.wees.2024.05.004

[15]

Fung, P., Dumont, G., Ries, C., Mott, C., & Ansermino, M. (2004). Continuous noninvasive blood pressure measurement by pulse transit time. In The 26th Annual International Conference of the IEEE Engineering in Medicine and Biology Society, 738-741. https://doi.org/10.1109/IEMBS.2004.1403264

[16]

Yoon, Y., Cho, J. H., & Yoon, G. (2009). Non—constrained blood pressure monitoring using ECG and PPG for personal healthcare. Journal of Medical Systems, 33(4), 261-266. https://doi.org/10.1007/s10916-008-9186-0

[17]

Kurylyak, Y., Lamonaca, F., & Grimaldi, D. (2013). A neural network—based method for continuous blood pressure estimation from a PPG signal. In 2013 IEEE International Instrumentation and Measurement Technology Conference, 280-283. https://doi.org/10.1109/i2mtc.2013.6555424

[18]

Sun, S., Bezemer, R., Long, X., Muehlsteff, J., & Aarts, R. M. (2016). Systolic blood pressure estimation using PPG and ECG during physical exercise. Physiological Measurement, 37(12), 2154-2169. https://doi.org/10.1088/0967-3334/37/12/2154

[19]

Tanveer, M. S., & Hasan, M. K. (2019). Cuffless blood pressure estimation from electrocardiogram and photoplethysmogram using waveform based ANN—LSTM network. Biomedical Signal Processing and Control, 51, 382-392. https://doi.org/10.1016/j.bspc.2019.02.028

[20]

Leitner, J., Chiang, P.—H., & Dey, S. (2022). Personalized blood pressure estimation using photoplethysmography: A transfer learning approach. IEEE Journal of Biomedical and Health Informatics, 26(1), 218-228. https://doi.org/10.1109/JBHI.2021.3085526

[21]

Tang, C., Liu, Z., & Li, L. (2022). Mechanical sensors for cardiovascular monitoring: From battery—powered to self—powered. Biosensors, 12(8), 651. https://doi.org/10.3390/bios12080651

[22]

Ion, M., Dinulescu, S., Firtat, B., Savin, M., Ionescu, O. N., & Moldovan, C. (2021). Design and fabrication of a new wearable pressure sensor for blood pressure monitoring. Sensors, 21(6), 2075. https://doi.org/10.3390/s21062075

[23]

Allen, J. (2007). Photoplethysmography and its application in clinical physiological measurement. Physiological Measurement, 28(3), R1-R39. https://doi.org/10.1088/0967-3334/28/3/R01

[24]

Moraes, J. L., Rocha, M. X., Vasconcelos, G. G., Vasconcelos Filho, J. E., de Albuquerque, V. H. C., & Alexandria, A. R. (2018). Advances in photopletysmography signal analysis for biomedical applications. Sensors, 18(6), 1894. https://doi.org/10.3390/s18061894

[25]

Kim, K. B., & Baek, H. J. (2023). Photoplethysmography in wearable devices: A comprehensive review of technological advances, current challenges, and future directions. Electronics, 12(13), 2923. https://doi.org/10.3390/electronics12132923

[26]

Simjanoska, M., Gjoreski, M., Gams, M., & Madevska Bogdanova, A. (2018). Non—invasive blood pressure estimation from ECG using machine learning techniques. Sensors, 18(4), 1160. https://doi.org/10.3390/s18041160

[27]

Craig Herndon, R. (2021). Determining signal entropy in uncertainty space. Measurement, 178, 109336. https://doi.org/10.1016/j.measurement.2021.109336

[28]

Motamedi—Fakhr, S., Moshrefi—Torbati, M., Hill, M., Hill, C. M., & White, P. R. (2014). Signal processing techniques applied to human sleep EEG signals—A review. Biomedical Signal Processing and Control, 10, 21-33. https://doi.org/10.1016/j.bspc.2013.12.003

[29]

Ibrahim, B., & Jafari, R. (2022). Cuffless blood pressure monitoring from a wristband with calibration—free algorithms for sensing location based on bio—impedance sensor array and autoencoder. Scientific Reports, 12(1), 319. https://doi.org/10.1038/s41598-021-03612-1

[30]

Griggs, D., Sharma, M., Naghibi, A., Wallin, C., Ho, V., Barbosa, K., ..., & Krishnan, S. K. (2016). Design and development of continuous cuff—less blood pressure monitoring devices. In 2016 IEEE Sensors, 1-3. https://doi.org/10.1109/ICSENS.2016.7808908

[31]

Sel, K., Osman, D., Huerta, N., Edgar, A., Pettigrew, R. I., & Jafari, R. (2023). Continuous cuffless blood pressure monitoring with a wearable ring bioimpedance device. npj Digital Medicine, 6(1), 59. https://doi.org/10.1038/s41746-023-00796-w

[32]

Cattivelli, F. S., & Garudadri, H. (2009). Noninvasive cuffless estimation of blood pressure from pulse arrival time and heart rate with adaptive calibration. In 2009 Sixth International Workshop on Wearable and Implantable Body Sensor Networks, 114-119. https://doi.org/10.1109/BSN.2009.35

[33]

Chu, Y., Tang, K., Hsu, Y.—C., Huang, T., Wang, D., Li, W., ..., & Shams, S. (2023). Non—invasive arterial blood pressure measurement and SpO2 estimation using PPG signal: A deep learning framework . BMC Medical Informatics and Decision Making, 23(1), 131. https://doi.org/10.1186/s12911-023-02215-2

[34]

Samimi, H., & Dajani, H. R. (2023). A PPG—based calibration—free cuffless blood pressure estimation method using cardiovascular dynamics. Sensors, 23(8), 4145. https://doi.org/10.3390/s23084145

[35]

Liu, Z.—D., Li, Y., Zhang, Y.—T., Zeng, J., Chen, Z.—X., Liu, J.—K., & Miao, F. (2024). HGCTNet: Handcrafted feature—guided CNN and transformer network for wearable cuffless blood pressure measurement. IEEE Journal of Biomedical and Health Informatics, 28(7), 3882-3894. https://doi.org/10.1109/JBHI.2024.3395445

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