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Abstract—Hypertension (high blood pressure) is the leading and the Signal to Noise ratio from Taguchi method is used to
cause for increasing number of premature deaths due to cardio- reject the noise and select the robust features from the PPG
vascular diseases. Continuous hypertension screening seems to signal. The feature selection method is applied to multiple
be a promising approach in order to take appropriate steps to
alleviate hypertension-related diseases. Many studies have shown regression analysis for Systolic BP estimation. Choudhury
that physiological signal like Photoplethysmogram (PPG) can be et al. in [3] use a 2-element Windkessel model to estimate
reliably used for predicting the Blood Pressure (BP) and Heart BP based on the PPG signal. Visvanathan et al. in [4] and
Rate (HR). However, the existing approaches use a transmission Kurylyak et al. in [5] use a large number of parameters
or reflective type wearable sensor to collect the PPG signal. These extracted from PPG for estimating the BP.
sensors are bulky and mostly require an assistance of a trained
medical practitioner; which preclude these approaches from Many researchers also introduce special sensor-based sys-
continuous BP monitoring outside the medical centers. In this tem to make the PPG collection procedure easier. Samria et al.
paper, we propose a novel touchless approach that predicts BP in [6] introduce a finger PPG sensor designed using an infra-
and HR using the face video based PPG. Since the facial video can red LED. The algorithm estimates BP using the PPG based
easily be captured using a consumer grade camera, this approach features, such as, systolic upstroke volume, diastolic time and
is a convenient way for continuous hypertension monitoring
outside the medical centers. The approach is validated using time delay. Ahmed et al. in [7] present a prototype that records
the face video data collected in our lab, with the ground truth PPG from the user’s head region (temple). The recorded PPG
BP and HR measured using a clinically approved BP monitor is used for estimating the BP. All these studies depend upon
OMRON HBP1300. Accuracy of the method is measured in terms a wearable sensor and a dedicated processing and acquisition
of normalized mean square error, mean absolute error and error unit, resulting in a bulky system that can induce discomfort to
standard deviation; which complies with the standards mentioned
by Association for the Advancement of Medical Instrumentation. the patient during continuous monitoring. These approaches
Two-tailed dependent sample t-test is also conducted to verify that are suitable only for in-house or clinical health monitoring.
there is no statistically significant difference between the BP and To make continuous hypertension monitoring a more com-
HR predicted using the proposed approach and the BP and HR mon practice, a completely touchless and cuffless solution is
measured using OMRON. required, that does not intrude much into day to day activity of
the user. Such solution should be less time consuming and easy
I. I NTRODUCTION
to use. Many state-of-the-art approaches suggest the extraction
Hypertension (High Blood Pressure) is one of the major of PPG signal distantly using the face or palm video. Some
causes of cardiovascular disease. It is a symptom-less condi- of these approaches are discussed below.
tion that mostly goes unnoticed and untreated, especially due Verkruysse et al. in [8] propose a method for remotely
to the lack of medical facilities or due to the busy lifestyle of measuring the PPG signal using the face video. Based on
potentially hypertensive population. An efficient solution to this PPG, the Respiratory Rate (RR) and HR is quantified
this is an ubiquitous hypertension monitoring system that can up to several harmonics. Poh et al. in [9] propose a low-cost
be used continuously for in-situ health tracking. Unfortunately, method for extracting the PPG signal based on face video
the prevalent ways for measuring accurate Blood Pressure (BP) recorded from the webcam. They use the PPG signal for
are cuff-based, bulky and costly, which cannot be used fre- quantifying HR, RR and HRV. Kumar et al. in [10], propose
quently without doctor’s supervision. In pursuit of finding the a new method, DistantPPG, that extracts a good quality PPG
compact and cuffless ways for monitoring the BP continuously, from the face video by overcoming the constraints like skin
researchers have rigorously analyzed the Photoplethysmogram color and motion artifacts. Sun et al. in [11] present a motion
(PPG) signal. Recent studies have proved that PPG can be artifact reduction technique that gives a good quality imaging
reliably used in BP and Heart Rate (HR) estimation. PPG signal using the face or palm video. This technique is
Fukushima et al. in [1] use the accelerated PPG waveform, suitable for measuring HR and RR during exercise.
Heart Rate Variability (HRV) and rate of PPG signal drift to Unfortunately, these approaches could only quantify HR,
estimate the BP. Suzuki et al. in [2] show how orthogonal array RR or HRV using the remotely recorded PPG. In a latest
Input Video Extraction of PPG signal Peak detection
Principal component and
Pre-processing Parameter extraction
analysis
Crop the face
Reconstruction
Video stabilization BP and HR estimation
Reconstruction Error
study by Jeong et al in [12], a high correlation of image Considering that the subject or the camera might have
based Pulse Transit Time (iPTT) is demonstrated with systolic moved during the video recording, all the frames are stabilized
BP. This study uses a high speed camera for recording the using a video stabilization technique [14]. Although the green
image based PPG (iPPG) and iPTT (using the face and palm channel features the strongest plethysmographic signal [8],
video). However, this study is limited to finding the range of the red and blue channels also contain plethysmographic
correlations only. information [15]. In this study, we use only the red channel
This paper draws motivation from all such previous studies. component of the RGB frames. Once we obtain the stabilized
T
We present an efficient novel approach for recording the PPG video, we generate the data matrix A = [a1 , a2 , · · · , aL ] ,
touchlessly using only the face video. Moreover, we use this where ai represents the column vector obtained by vectored
PPG to estimate the HR as well as systolic and diastolic BP, representation of red channel component of ith frame. A
unlike other studies. A face video of the subject is processed ∈ RL×M ; where L is the total number of frames in the video
to extract the corresponding PPG signal. Time [4][5] and and M is M1 .M2 .
frequency domain parameters are obtained from this PPG
B. Extraction of PPG Signal
signal. Finally, BP and HR are estimated based on these
extracted parameters. The BP and HR estimation accuracy of Assuming that the lighting conditions and camera settings
the proposed approach shows that it can be safely used for were constant throughout the recording, any intensity variation
continuous and non-invasive hypertension screening. observed in the red channel should be due to the variation
The remaining paper is organized as follows: Section II in the blood that flows beneath the face skin. To extract
discusses how PPG signal can be extracted using the proposed these variations from the video, we use Principal Component
approach. It shows the estimation of BP and HR based on the Analysis (PCA) [16]. Once we have the matrix A that carries
extracted PPG signal. Section III describes the experimental intensity of the red channel of the video frames, PCA is
set-up used to verify the proposed approach. It shows the performed on A. In order to extract PPG signal, we compute
0
accuracy of the approach by testing it on a database collected the error between A and the reconstructed matrix A . Here,
0
in our lab. The paper concludes with Section IV, which A is determined by using only n principal components of A,
discusses the advantages and future scope of the proposed where n is decided experimentally. The reconstruction error
approach. represents the minute changes in the pixel intensity that occur
due to the variation in the blood flowing beneath the face skin.
II. M ETHODOLOGY This error is proportional to the PPG signal and is given as:
This section explains the method used for extracting the
PPG signal from the face video. It also shows how BP and APPG = A0 − A (1)
HR are estimated based on the extracted PPG. A complete Each row in matrix APPG is reshaped back in its original
process flow of the proposed approach is shown in fig. 1 and size (that is, original face cropped frame size, M1 × M2 ).
is subsequently explained as follows: This gives us a sequence of L error video frames, B i , where
A. Video Collection and Pre-processing i represents the ith frame. From each frame, the PPG signal
A face video of the subject is recorded (in ambient lighting content, P P Gi , is obtained using the following expression:
conditions) by keeping the camera still at about half meter
distance from the face. The video is recorded for the duration 1 XM1 XM2
i
P P Gi = Bjk ∀ i = 1, 2, · · · L (2)
of one minute, while the subject is asked to sit still with the (M1 M2 ) j=0 k=0
eyes closed. The PPG signal is extracted using only the face Since frequency range of the PPG signal is 0.5–5 Hz [17],
region of the video, so to clip off any extra portion in the video high frequency noise is removed from the obtained PPG signal
frames, KLT (Kanade-Lucas-Tomasi) face detection algorithm (P P G1:L ) using a bandpass filter with cut-off frequency [0.5,
is used [13]. A new video is created that contains only the 5] Hz [11]. In the next section, we describe the peak detection
face of the subject, having M1 × M2 frame size. and parameter extraction performed on the filtered PPG signal.
Fig. 2. Peak detection in the PPG signal extracted from face video Fig. 4. Calculating dominant frequency in the PPG signal
TABLE I
PARAMETERS E XTRACTED F ROM THE PPG S IGNAL
_ _ ---------------------------------------------------------------------------------------
---------------------------------------------------------------------------------------
PPG Pulse
PeakN+2
AP _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ _ PeakN
_____________________________________
<----------------------------PPG HeightN------------------------------>
Time [4][5] T 2N +1 − T 2N = PP
T 1N +1 − T 1N = FF
T 2N − T 1N = PF
Amplitude
Dicrotic NotchN
AD _ _ _ _ Dicrotic
________________
Notch Dicrotic NotchN+1
N-1
T 1N +1 − T 2N = FP
_________________________
_______________________
PP/FF
PP/FP
FP/FF
FP/PF
PPG Height(AP )
AF and AD Heights
FootN+2 (T 2N − T IN ) = Crest time
FootN FootN+1
AF_ _ _ _ _ _ _ _ _ _ _ _ <--------PPG WidthN------->
P T 3N
___