UMMS Affiliation

Department of Psychiatry

Publication Date


Document Type



Analytical, Diagnostic and Therapeutic Techniques and Equipment | Biomedical Devices and Instrumentation | Cardiovascular Diseases | Diagnosis | Telemedicine


Elevated blood pressure (BP) is a major cause of death, yet hypertension commonly goes undetected. Owing to its nature, it is typically asymptomatic until later in its progression when the vessel or organ structure has already been compromised. Therefore, noninvasive and continuous BP measurement methods are needed to ensure appropriate diagnosis and early management before hypertension leads to irreversible complications. Photoplethysmography (PPG) is a noninvasive technology with waveform morphologies similar to that of arterial BP waveforms, therefore attracting interest regarding its usability in BP estimation. In recent years, wearable devices incorporating PPG sensors have been proposed to improve the early diagnosis and management of hypertension. Additionally, the need for improved accuracy and convenience has led to the development of devices that incorporate multiple different biosignals with PPG. Through the addition of modalities such as an electrocardiogram, a final measure of the pulse wave velocity is derived, which has been proved to be inversely correlated to BP and to yield accurate estimations. This paper reviews and summarizes recent studies within the period 2010-2019 that combined PPG with other biosignals and offers perspectives on the strengths and weaknesses of current developments to guide future advancements in BP measurement. Our literature review reveals promising measurement accuracies and we comment on the effective combinations of modalities and success of this technology.


PPG signal, biomedical engineering, blood pressure measurement, digital health, digital medicine, hypertension assessment, hypertension diagnosis, photoplethysmogram, pulse arrival time, pulse oximetry, wearable devices, wearable technology

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© 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (

DOI of Published Version



Welykholowa K, Hosanee M, Chan G, Cooper R, Kyriacou PA, Zheng D, Allen J, Abbott D, Menon C, Lovell NH, Howard N, Chan WS, Lim K, Fletcher R, Ward R, Elgendi M. Multimodal Photoplethysmography-Based Approaches for Improved Detection of Hypertension. J Clin Med. 2020 Apr 22;9(4):E1203. doi: 10.3390/jcm9041203. PMID: 32331360. Link to article on publisher's site

Journal/Book/Conference Title

Journal of clinical medicine


Full author list omitted for brevity. For the full list of authors, see article.

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Creative Commons License

Creative Commons Attribution 4.0 License
This work is licensed under a Creative Commons Attribution 4.0 License.