Capturing Physiological Correlates of Stress-Induced Blood Pressure Elevation Using a Multimodal Wearable Sensing Patch in Patients with a History of Myocardial Infarction.

Persons who have experienced a prior myocardial infarction (MI) are at a greater risk of experiencing a secondary event. External factors, such as stress, can cause transient hypertension, further increasing cardiovascular disease risk. However, challenges to monitoring stress-induced hypertension include obtrusiveness of monitoring devices, unknown validity in high-risk populations, and unsubstantiated sensitivity in stressful environments. In this pilot study, we investigated data from a validated, multimodal, wearable patch to examine physiological correlates of laboratory-based hypertensive stress responses. The device collected electrocardiogram, seismocardiogram, and photoplethysmogram signals from 35 participants (26 post-MI and 9 healthy participants) during a protocol involving a public speaking stressor. We calculated the change from rest to stress in 10 features extracted from these signals and assessed their correlation to stress-induced changes in mean arterial pressure (MAP) derived from a validated brachial pressure cuff. MAP changes correlated significantly with changes in heart rate (p<0.001, r=0.69), left ventricular ejection time (p<0.001, r=-0.63), pulse arrival time (p<0.001, r=-0.58), and pulse transit time (p<0.001, r=-0.56) captured by the patch.Clinical relevance- We demonstrate the potential of a multimodal patch to capture multiple physiological correlates of stress-induced hypertension with moderate dose-response effect sizes. Future work with larger populations could combine these physiological correlates for the purpose of cardiovascular risk stratification using low-burden technologies.