Literature Review Aarthi Sivasankar

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1 Literature Review Aarthi Sivasankar Table of Contents Importance of Blood Pressure How Blood Pressure Monitoring Devices Work Measurements Involved in Taking Blood Pressure Materials Needed for Taking Blood Pressure Blood Pressure Measurement Procedure Efficiency Problems with Tracking Blood Pressure Doctor Visits for Checking Blood Pressure Can Become Tedious Overtime Alternative Method to Measuring Blood Pressure: Digital Blood Pressure Monitors Digital Pressure Monitors Can Cause Lack of User Convenience Smart Technology Revolutionizes Today s Society Medical Applications on Smartphones and Other Smart Devices Medical Applications Can Never Replace Doctor Visits The Arduino Interface Android Studio Interface Development Environment Medical Applications on Android Studio Engineering Plan

2 Importance of Blood Pressure Unfortunately, there has been a lot more deaths caused by hypertension, a state of abnormally high blood pressure, than heart diseases since the year of According to the American Heart Association, there were growing concerns over a 13 percent uptick in hypertension-related deaths in 2015 (American Heart Association, 2015). Even though there has been a continuous drop in the number of heart disease and stroke related deaths since 2015, there has been an increase in the number of high blood pressure related deaths (American Heart Association, 2015). It is just as important to regularly monitor blood pressure as it is to monitor heart rate and other commonly measured health factors. This routine monitoring is important because blood pressure is a critical element of life that can affect an individual s future. For example, if an individual does not take care of his or her high blood pressure status at an early stage, it can cause a lot of medical concerns in the future possibly even life-threatening concerns. High blood pressure can eventually cause the arteries and heart to thicken and weaken. The heart will have to put in extra effort to pump blood throughout the body, and, as a result, the arteries are more prone to becoming clogged, causing unnecessary medical concerns (Blood Pressure UK, 2008). Therefore, it is absolutely vital for all individuals to take the time to regularly track their blood pressure status to ensure their health for their future. How Blood Pressure Monitoring Devices Work Measurements Involved in Taking Blood Pressure There are many measurements that are involved in the process of taking blood pressure. In general, one s final blood pressure reading includes both the systolic and diastolic pressure

3 measurements. Once the cuff is inflated, blood flow will temporarily be cut off. As the cuff starts to deflate, the systolic pressure will be calculated. The systolic pressure is the pressure of blood on the artery walls while the heart pumps blood. This measurement occurs when the cuff starts to deflate because blood flow will return at this time. In other words, when the pressure starts to decrease and blood flow returns, the pressure reading at which the sound of blood flow is first heard will be the systolic pressure. As the pressure continues to decrease, the diastolic pressure will be measured. The diastolic pressure is the pressure on the artery wall between heart beat rests. In other words, the pressure reading at which the blood flow settles determines the diastolic pressure. The ratio of the systolic to diastolic pressure will be the final blood pressure reading, which is expressed in mmhg units (millimeters Mercury), as shown below in Figure 1. Figure 1: This is an example of a final blood pressure reading in mmhg. The top number represents the systolic pressure while the bottom number represents the diastolic pressure (Hypertension Talk, 2012). Materials Needed for Taking Blood Pressure There are several materials that are needed for taking blood pressure. However, the types of materials needed depend upon which method is used. For manually checking blood pressure, one would need a blood pressure cuff and a stethoscope, as shown in Figure 2 (Livestrong, 2015). The blood pressure cuff would be the armband that the individual would wear on his or her arm. In addition, the blood pressure cuff should have an inflation pump, pressure release valve, and a

4 manometer gauge. The inflation pump allows the cuff to inflate, causing the individual s arm to pressurize. The valve allows the pressure from the inflation pump to release, and the manometer gauge allows the doctor to determine the systolic and diastolic pressure reading (Livestrong, 2015). The stethoscope is needed to determine the time at which the first heart beat is heard and the time at which the blood flow settles at a normal speed as the cuff starts to deflate (Livestrong, 2015). For digitally checking blood pressure, the only medical instrument an individual would need would be a digital blood pressure monitor with a cuff, as shown in Figure 3. This is because the digital monitor will be programmed to calculate the systolic and diastolic pressure algorithmically within the device. The monitor will ultimately display the the blood pressure reading on the screen. Figure 2: These are the materials one would need to manually check their blood pressure. The cuff will include the inflation pump, air release valve, and manometer gauge. The stethoscope is used to determine the the time at which the blood flow can be heard (Litmann, Nurses Store, 2013). Figure 3: The digital monitor is the only device one would need to electronically check their blood pressure. The digital monitor will have a button that will inflate the cuff, and will be programmed to display the resulting blood pressure reading on the screen, as shown above (Regulate Blood Pressure, 2016). Blood Pressure Measurement Procedure All individuals who want to maintain healthy lifestyles must use some type of blood pressure monitoring device to check their health status in a regular manner. However, no matter what the device, all of the processes that occur to successfully output an individual s blood pressure

5 status are the same. After the individual fastens the armband, he or she must do one of two things. If using an analog device, the individual must squeeze the inflation pump, otherwise, if using a digital device, the individual must press a button that serves the purpose of an inflation pump. Both of these actions result in the inflation of the armband. During this time, the device will measure the systolic pressure. Specifically, the systolic pressure is when the sensor senses the first heart beat as the cuff starts to deflate (American Heart Association, 2015). Subsequently, after the systolic pressure is found, the device will measure the diastolic pressure. Specifically, the diastolic pressure is when the sensor senses the blood flow returning back to normal during the deflation stage (American Heart Association, 2015). In conclusion, the ratio of the systolic pressure to the diastolic pressure represents the individual s blood pressure status. Figure 4 shows the procedure for taking both the systolic and diastolic measurement readings. Figure 4: This diagram depicts the procedure when taking both the systolic and diastolic pressure. Systolic pressure is taken once the blood slowly starts to flow within the artery as the cuff deflates. Diastolic pressure is taken once the blood flow goes back to normal (Free Dictionary). Efficiency Problems with Tracking Blood Pressure

6 There are many methods for tracking blood pressure. Some individuals may visit the doctor s office to check their blood pressure, while others may prefer to use a digital blood pressure monitor that can be operated at home. While these may be acceptable methods, they may not always be the most efficient methods. Visiting the doctor s office often for blood pressure checkups may become very tedious over time, whereas a digital blood pressure monitor may not be the most user-convenient device for patients on the go. Individuals can also consider purchasing a manual blood pressure device for home usage, but they may tend to not get accurate readings when they measure their blood pressure by themselves using a non-electronic measuring device. The above mentioned methods are described in detail in the following sections. Doctor Visits for Checking Blood Pressure Can Become Tedious Overtime The most common method for checking blood pressure before digital blood pressure monitors existed would be for one to get his or her blood pressure checked by a doctor. While this method is acceptable, it can become very tiring for the individual to constantly have to visit the doctor just to get his or her blood pressure checked. Nevertheless, having a doctor check one s blood pressure can provide accurate blood pressure readings, despite slight inevitable human errors that can occur at times. But a patient should not have to visit the doctor s office ten times if he or she wants to check his or her blood pressure ten times in a week. This approach would be impractical to take. Therefore, doctor visits may not always be the best choice of method for monitoring blood pressure. Alternative Method to Measuring Blood Pressure- Digital Blood Pressure Monitors

7 Rather than visiting the doctor s office whenever tracking blood pressure statuses, an alternative method would be to purchase a digital blood pressure monitor. However, the next section describes how digital monitors can be just as ineffective as doctor visits. Digital Pressure Monitors Can Cause Lack of User Convenience While blood pressure monitors can be very beneficial, they may not always be the most efficient methods for tracking blood pressure. Digital blood pressure monitors can provide very accurate blood pressure readings, but their main purpose is for at home usage only. With most of the people in the society having to go to work these days, it would be very rare to find people in their homes for most of the day. Moreover, there may be certain heart patients who would like to monitor their blood pressure status more often than others. In this case, it would be very frustrating for them to have to carry a digital blood pressure monitor with them wherever they go, whether it may be when working, when travelling, or during any other situation. Thus, blood pressure monitors create a lack of user convenience for patients, which can prevent them from checking their blood pressure status when necessary. Therefore, there must be a new alternative method designed in such a way that it is efficient and user-convenient for any individual to check their blood pressure at any given place or time. Especially with smart devices revolutionizing our society today, medical applications on smartphones can provide for user convenience when monitoring blood pressure, as explained in the next section. Smart Technology Revolutionizes Today s Society Many people in our society today can be found using some type of smart device, whether it may be smartphones, tablets, portable music devices, or any other widely used smart device. In

8 fact, according to Statista, there will be approximately 2.32 billion worldwide smartphone users by the end of 2017 (Statista, 2016). One common reason that there will be so many smart technology users in the future is because smart technology provides for a greater range of user convenience. Smart devices are designed to help humans with completing difficult or time consuming tasks with ease. While smart technology can be used for pleasure, entertainment, and social media, it can also be used for important necessities as well, namely medical necessities, as explained in detail in the following section. Figure 5: Wherever an individual goes, he or she can find most of the society using all types of smart technology. This is due to our society revolutionizing in smart technology as the centuries advance. Smart technology provides user-convenience for its users (Govtech, 2016). Medical Applications on Smartphones and Other Smart Devices There are many types of medical smartphone applications available for a variety of purposes, such as checking heart rate, pulse, eye conditions, etc. These medical apps can be very beneficial because they allow a patient to quickly check their health status in an easy, user-efficient way. Moreover, smartphones are portable, therefore patients on the go can easily check their health

9 at any time and any place. For example, it would be very difficult to check heart rate without some type of device or medical instrument, therefore app developers have designed a variety of heart rate apps that can effortlessly check one s heart rate and report back his or her status. Some applications even allow users to send these statuses to their doctors directly from the smart device, which eliminates the entire trip to the doctor s office. Ultimately, medical smartphone applications can provide a pleasant user experience due to the user-friendliness of the applications. However, even though these applications can be tremendously useful, they are no substitute to actual doctor visits, as explained in the next section. Figure 6: Smartphones can now provide so much more than entertainment, GPS services, music, and more. They can provide medical applications that can be used anywhere at anytime (Independent Traveler, 2016). Medical Applications Can Never Replace Doctor Visits Despite how medical applications can be advantageous, it is very critical to remember that these can never replace the traditional doctor check ups that should occur periodically. The reason is because doctors, by far, are the most reliable sources for medical assistance. Whenever one has a very serious medical issue, he or she must consult to a doctor rather than some type of medical

10 app or device. However, sometimes, as mentioned several sections above, going to the doctor s office for every minute issue can be very tedious. This tediousness is why medical apps are out there. Every now and then, if patients need to monitor little aspects of health, they may consult to medical applications. However, when more critical concerns arise, the best decision would be to turn to a doctor for the most excellent, accurate solutions. The Arduino Interface Arduinos are remarkable open source platforms that are commonly used for electronic and engineering projects. The Arduino consists of two parts, namely the microcontroller and the Integrated Development Environment (IDE). The microcontroller can be commonly referred to the printed circuit board (PCB) that is programmable with the Arduino IDE. The IDE is a unique piece of Arduino software that allows one to write and export computer code to the actual physical Arduino board (Sparkfun, 2016). Arduino platforms are very beneficial because unlike most other programmable PCB s, the Arduino does not need an additional hardware known as a programmer for exporting new code from the computer software to the physical board. One of the major items it needs is just a USB cable, which makes it a very advantageous tool for most engineering projects (Sparkfun, 2016). Figure 7: The image above portrays an Arduino Uno Electronic Platform (Arduino, 2016).

11 Android Studio Interface Development Environment Android Studio is the Official Integrated Development Environment for Android App Development. Most of the apps on the Google Play Store have been developed using Android Studio because Android Studio is the basic app development environment for Android. It provides a lot of distinctive testing tools and frameworks, as well as provides a uniform environment where apps can be developed for all types of Android devices (Android Studio, 2016). Medical Applications on Android Studio Similar to how entertainment apps can be created on Android Studio, medical applications can also be developed on Android Studio. A common example of a medical/health app would be a Fitbit. A Fitbit is designed to calculate how many calories one burns, how many steps one walks, etc. The Fitbit wristband then syncs this data to the Fitbit app, where the data will be displayed. The app displaying the data and providing notifications are all features that can be accomplished on Android Studio in the app development process.

12 Engineering Plan Engineering Problem The lack of an efficient and user-convenient blood pressure monitor prevents busy patients from tracking their accurate blood pressure status, which can cause future health problems if not monitored properly. Engineering Goals & Expected Outcomes The engineering goal is to engineer a user-convenient and efficient sensor based blood pressure monitoring device that will monitor one's blood pressure status on a cost free Android smartphone app. This relates to my rationale above because this user-friendly measuring device is designed to instantaneously display the user s blood pressure status, to allow users to notify their doctors of their health results, and to provide a range of user-advantageous features on an absolutely costfree smartphone app. Procedure 1. Implementing Necessary Sensors: The first step is to implement the pressure and pulse sensor with the structure of the armband. This implementing is so that the armband is able to accurately sense the pressure of the cuff when it is inflated on an individual s arm. 2. Data Collection: Both the pressure and pulse sensor must collect their respective data but convert that data into the systolic and diastolic pressure measurements based on the algorithm that will be created. 3. Designing the App: The Android Studio IDE will aid in creating the cost-free Android smartphone app. This app will display the user s final blood pressure reading in mmhg. The systolic and diastolic measurements attained through data analysis will be used to display the final blood pressure on the app. The app will also notify the user if they have

13 not checked their blood pressure for a long time or have very poor blood pressure, as well as provide a lot of user-friendly features that will allow patients to use this app with ease. 4. Sending Signals: Both the pressure and pulse sensor must be able to send the systolic and diastolic data through Bluetooth signals from the Arduino software, to the Android Smartphone App. 5. Test the App: An Android smartphone supplied by the school will be used to test the app to verify if it provides accurate blood pressure information as well as performs all of the user-convenient features available. Decision Criteria: The device will be mainly based off of two criteria. The first criteria is that the device is userconvenient. In other words, the device must be user-friendly and easy to use. My second criteria is that device is efficient and provides accurate results. Thus, an already pre-existing blood pressure cuff is used with my device so that it will produce accurate blood pressure readings.

14 References A. (2013, November 11). Understanding a Manual Sphygmomanometer - Nurses Store. Retrieved December 07, 2016, from Android Studio Basics (n.d.). Meet Android Studio. Retrieved October 19, 2016, from Arduino- Introduction. (n.d.). Retrieved October 18, 2016, from Berger, A. (2001, October 20). Oscillatory Blood Pressure Monitoring Devices. Retrieved October 20, 2016, from Blood Pressure definition of blood pressure by Medical dictionary. (n.d.). Retrieved December 07, 2016, from pressure Digital Blood Pressure Monitor. (2016). Retrieved December 07, 2016, from High Blood Pressure Causing More Deaths Despite Drop in Heart Disease, Stroke Deaths - News on Heart.org. (2015). Retrieved November 20, 2016, from How Does a Blood Pressure Cuff Work? (2015). Retrieved November 20, 2016, from "How Smartphones Revolutionized Society in Less than a Decade." Government Technology. GovTech, 20 Nov Web. 22 Dec Kosciolek, A. (n.d.). Six Travel Apps for Medical Emergencies- Independent Traveler. Retrieved December 22, 2016, from Meet Android Studio. (n.d.). Retrieved December 05, 2016, from Number of Smartphone Users Worldwide Statista. (n.d.). Retrieved December 05, 2016, from (n.d.). Retrieved December 7, 2016, from &rt=rud

15 Understanding and Managing High Blood Pressure American... (n.d.). Retrieved October 20,2016, Understanding Blood Pressure Measurement & Numbers - Hypertension Talk. (2012). Retrieved December 07, 2016, from Understanding Blood Pressure Readings. (2016, November 7). Retrieved November 20, 2016, from Blood-Pressure-Readings_UCM_301764_Article.jsp#.WDH4LsesnAc What is an Arduino? (n.d.). Retrieved December 05, 2016, from Why Blood Pressure Matters. (2008). Retrieved November 20, 2016, from

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