Automated analysis of finger blood pressure recordings provides insight in determinants of baroreflex sensitivity and heart rate variability—the HELIUS study

• Published in: Medical & biological engineering & computing 2023-05, Vol.61 (5), p.1183-1191
• Main Authors: Collard, D., Westerhof, B. E., Karemaker, J. M., Stok, W. J., Postema, P. G., Krediet, C. T. P., Vogt, L., van den Born, B. J. H.
• Format: Article
• Language: English
• Subjects: Age; Automation; Baroreceptors; Baroreflex - physiology; Biomedical and Life Sciences; Biomedical Engineering and Bioengineering; Biomedicine; Blood pressure; Blood Pressure - physiology; Body mass; Body mass index; Body size; Cohort analysis; Computer Applications; Cross correlation; Female; Finger; Fingers; Heart rate; Heart Rate - physiology; Human Physiology; Humans; Hypertension; Imaging; Intervals; Male; Middle Aged; Original; Original Article; Pathogenesis; Radiology; Reflexes; Sex; Women
• ISSN: 0140-0118; 1741-0444
• DOI: 10.1007/s11517-023-02768-4

Sympathovagal balance is important in the pathogenesis of hypertension and independently associated with mortality. We evaluated the value of automated analysis of cross-correlation baroreflex sensitivity (xBRS) and heart rate variability (HRV) and its relationship with clinical covariates in 13,326 participants from the multi-ethnic HELIUS study. Finger blood pressure (BP) was continuously recorded, from which xBRS, standard deviation of normal-to-normal intervals (SDNN), and squared root of mean squared successive difference between normal-to-normal intervals (RMSDD) were determined. A subset of 3356 recordings > 300 s was used to derive the minimally required duration by comparing shortened to complete recordings, defined as intraclass correlation (ICC) > 0.90. For xBRS and SDNN, 120 s and 180 s were required (ICC 0.93); for RMSDD, 60 s (ICC 0.94) was sufficient. We included 10,252 participants (median age 46 years, 54% women) with a recording > 180 s for the regression. xBRS, SDNN, and RMSDD decreased linearly up to 50 years of age. For xBRS, there was a signification interaction with sex, with for every 10 years a decrease of 4.3 ms/mmHg (95%CI 4.0–4.6) for men and 5.9 ms/mmHg (95%CI 5.6–6.1) for women. Using splines, we observed sex-dependent nonlinearities in the relation with BP, waist-to-hip-ratio, and body mass index. Future studies can help unravel the dynamics of these relations and assess their predictive value. Graphical Abstract Panel 1 depicts automatic analysis and filtering of finger BP recordings, panel 2 depicts computation of xBRS from interpolated beat to beat data of systolic BP and interbeat interval, and (IBI) SDNN and RMSDD are computed directly from the filtered IBI dataset. Panel 3 depicts the results of large-scale analysis and relation of xBRS with age, sex, blood pressure and body mass index.