Cuffless blood pressure monitoring technology for wearables and medical devices

Non-invasive. 24/7. Clinically proven.

A man wearing a cuffless blood pressure monitor

CSEM’s patented optical blood pressure monitoring (oBPM) technology enables 24/7, non-invasive tracking of blood pressure (BP) without a cuff, providing comfortable and effective BP management. Using photoplethysmography (PPG) sensors and advanced pulse wave analysis (PWA) algorithms, oBPM delivers real-time measurements with clinical-grade accuracy across multiple body sites.

Validated against invasive gold-standard measurements and meeting ISO 81060-2 accuracy and precision targets, CSEM’s cuffless oBPM technology offers a proven solution for 24/7 systolic, diastolic, and mean BP monitoring. With applications ranging from acute intraoperative settings to long-term home monitoring, it provides comprehensive cardiovascular insights. Whether you are developing wearables, medical devices, or telemedicine solutions, our technology allows you to leapfrog traditional R&D cycles. In partnership with CSEM, device manufacturers and healthcare providers can rapidly bring cuffless BP monitoring to their users, giving them a competitive edge in cardiovascular care.

Companies using CSEM's oBPM technology today

CSEM’s cuffless BP monitoring solution has been rigorously validated in clinical settings, with particular emphasis put on its ability to track BP variations (trending ability). Leading innovators in digital health have already adopted our oBPM technology, demonstrating compelling real-world applications across diverse form factors.

Each company has a unique approach, and we help take it further by combining accuracy with real-world usability. This collaborative drive, combined with growing clinical acceptance, is rapidly moving us toward a future where managing BP is as easy as glancing at your watch or phone, thereby improving clinical outcomes as well as hypertension diagnosis and management.

Why is oBPM effective?

  • Cuffless 24/7 monitoring: Without depending on intermittent inflatable cuff readings, oBPM captures BP data without interruption, enabling comfortable, unobtrusive, round-the-clock wear at body sites such as the finger, wrist, or upper arm.
  • Accuracy: Clinically validated across diverse use cases, from acute intraoperative settings to long-term home monitoring for hypertension management, oBPM shows tight correlation with invasive and cuff-based references in tracking blood pressure variations, requiring only a one-time calibration for months of reliable BP tracking.
  • Flexible integration options: oBPM seamlessly works across diverse hardware platforms and form factors (such as smart rings, watches, phone cameras, or armpods). This enables its integration into multiparametric PPG-based monitoring solutions—such as CSEM’s DELTA research platform—for comprehensive cardiovascular assessment jointly with arrhythmia detection, SpO₂, sleep profiling, and stress analysis.

By being cuffless, oBPM shows a much higher patient acceptance and adherence than conventional cuff-based BP monitors, allowing 24/7 uninterrupted monitoring over weeks and months. Uninterrupted data collection reveals more representative and accurate circadian BP pattern assessment—from crucial nocturnal dips to morning surges, to activity- or treatment-related BP fluctuations—that traditional intermittent cuff-based BP monitors simply cannot detect through isolated readings. These data-driven insights enable better-informed treatment decisions, leading to increasingly personalized and effective hypertension management strategies.
   

Artistic background for blood pressure monitoring

Ready to explore cuffless blood pressure monitoring for your device?

CSEM's team of digital health experts is available to discuss how our clinically validated oBPM technology can be integrated into your specific application. Whether you are developing wearables, medical devices, or telemedicine solutions, we can provide technical insights and explore potential collaboration opportunities in line with your product roadmap.

Clinical validation studies

Leveraging advanced PWA algorithms, our oBPM technology extracts accurate BP values from PPG signals, and has been clinically validated across diverse use cases, including:

  • Clinical settings: The ability to detect rapid and large BP variations in acute contexts is critical. Our studies in operating rooms, during general anesthesia induction and surgery, as well as in intensive care units, demonstrate concordance rates (CR) ranging from 94% to 100% on BP changes tracking, when comparing oBPM applied to finger PPG signals to invasive arterial line references.
  • 24-hour ambulatory BP monitoring: While nighttime BP and the crucial nocturnal dip are among the strongest predictors of cardiovascular risk, cuff-based BP monitors are notorious for being poorly suited to measure BP during sleep, highlighting the need for a cuffless solution. Our study in 24-h ambulatory BP monitoring (ABPM) demonstrates agreement with cuff-based ABPM, complying with the ISO 81060-2 accuracy and precision limits, along with a CR of 98.5% on nocturnal BP dip tracking.
  • Hypertension management: Adequate hypertension control and therapy follow-up require frequent cuff-based BP measurements, often associated with poor patient adherence, leaving a crucial need for a cuffless alternative. Our study in hypertensive patients undergoing antihypertensive therapy shows that large BP variations between visits to the clinics could be tracked by oBPM using upper-arm PPG signals, with a CR of 95.5% and 95.7% for systolic and diastolic BP, respectively.

While it can track BP changes in mmHg without any calibration, oBPM requires initialization through a single-point calibration, typically using a cuff-based BP device, to estimate absolute BP values. Our study in subjects followed up over a 4-month period post-calibration demonstrates that oBPM maintains good accuracy and precision at all times (bias within ±5 mmHg, standard deviation (SD) < 8 mmHg).

Ongoing clinical studies and research projects

a pregnant woman sitting on a sofa

CSEM is actively advancing oBPM through longitudinal studies that evaluate long-term accuracy and clinical relevance. Current research includes:

  • Monitoring week-to-month BP variability in hypertensive patients newly introduced to an antihypertensive therapy or with substantial intensification of their current dosage;
  • Tracking day-to-day BP variability in postpartum women with preeclampsia in the first week following delivery, with follow-up visits one and three months postpartum.

In-lab investigations of hypotensive events in patients with autonomic nervous system disorders are also ongoing, with the goal of allowing evaluation of hemodynamic instability symptoms in real-life conditions for improved treatment guidance using a wearable PPG sensor.

Additionally, research in contactless BP estimation using remote PPG via camera-based systems are underway, demonstrating strong potential for inconspicuous monitoring in a preliminary feasibility study.

Our research also focuses on calibration-free BP estimation using machine learning models. These innovations aim to eliminate the need for initial cuff-based calibration while maintaining clinical accuracy. Deep learning architectures, including convolutional and transformer-based models designed to capture long-range dependencies and improve robustness under dynamic conditions for BP estimation from PPG, have shown promising results in intraoperative settings.

All of these ongoing clinical studies and research projects are driving oBPM even further, improving BP monitoring in clinical use cases and patient populations where a strong clinical need for a cuffless 24/7 BP solution remains to this day unmet.  

Partner with CSEM's oBPM Team

Our scientists and engineers are actively advancing the frontiers of cuffless BP monitoring through ongoing clinical studies and technological innovations. If you are interested in collaborative research opportunities or would like to discuss how our latest findings could benefit your specific application, we welcome the opportunity to explore potential partnerships that will drive the field forward together.

Science behind oBPM

  • Automated Pulse Oximeter Waveform Analysis to Track Changes in Blood Pressure During Anesthesia Induction: A Proof-of-Concept Study, Ghamri, Y., Proença, M. et al, Anesthesia & Analgesia 130(5):p 1222-1233, May 2020 | DOI: 10.1213/ANE.0000000000004678.
    In this study, oBPM applied to fingertip PPG signals from a conventional pulse oximeter tracks rapid systolic (SBP), mean (MBP) and diastolic (DBP) blood pressure changes during general anesthesia induction, showing CR up to 100% on trending ability with the invasive gold standard.
       
  • Method-comparison study between a watch-like sensor and a cuff-based device for 24-h ambulatory blood pressure monitoring, Proença, M., Ambühl, J., Bonnier, G. et al.,  Sci Rep 13, 6149 (2023) |  DOI: 10.1038/s41598-023-33205-z (open access).
    In this 24-h ABPM study, oBPM applied to wrist and upper arm PPG signals shows good agreement (bias within ±5 mmHg, SD < 8 mmHg) with ambulatory cuff-derived 24-h, daytime and nighttime SBP and DBP values, and a CR of 98.5% on nocturnal dipping tracking.
       
  • Tracking Blood Pressure Changes in Hypertension Management with a Cuffless Wearable Device, Proença, M., Bonnier, G., Ferrario, D., et al., Abstracts of the 2025 Joint Annual Conference of Biomedical Engineering / Biomedizinische Technik, vol. 70, no. s1, 2025, p. 297 | DOI: 10.1515/bmt-2025-1001.
    oBPM applied to upper arm PPG signals in hypertensive patients followed up in four clinical visits over 6 weeks demonstrates good trending ability (CR of 95.5% on SBP and 95.7% on DBP) in tracking large visit-to-visit BP changes when compared to a conventional oscillometric BP monitor.
       
  • Cuffless Blood Pressure Monitoring: Precision is Maintained four Months after Calibration, Proença, M., Aguet, C., Bonnier, G., et al., CSEM Scientific and Technical Report 2024, p. 101.
    oBPM applied to fingertip and upper arm PPG signals shows post-calibration stability (bias within ±5 mmHg, SD < 8 mmHg) up to four months after calibration, and excellent trending ability (CR = 100%) in tracking isometric exercise-induced SBP and DBP changes when compared to a conventional oscillometric BP monitor.
       
  • Blood Pressure Monitoring in People with Spinal Cord Injury, Proença, M. et al., CSEM Scientific and Technical Report 2023, p. 50.
    oBPM applied to upper arm PPG signals in individuals with spinal cord injury during episodes of hemodynamic instability post-surgery shows good trending ability (CR of 95% SBP, and 94% on MBP and DBP) when compared with the invasive gold standard. 
        
  • Contactless Tracking of Blood Pressure Changes Using Cameras, Bonnier, G., Aguet, C., Proença, M., et al, Abstracts of the 2025 Joint Annual Conference of Biomedical Engineering / Biomedizinische Technik, vol. 70, no. s1, 2025, p. 189 | DOI: 10.1515/bmt-2025-1001.
    In this feasibility in-lab study, oBPM applied to remote PPG (facial video) tracks isometric exercise-induced BP changes with a CR of 97.7% for SBP and 96.9% for DBP.
       
  • Blood pressure monitoring during anesthesia induction using PPG morphology features and machine learning, Aguet, C., et al, PLoS ONE 18(2): e0279419 | DOI: 10.1371/journal.pone.0279419 (open access).
    In this study, a calibration-free machine learning-based adaptation of oBPM applied to fingertip PPG signals showed similar excellent trending ability as oBPM (CR of 100% and 98% for SBP and DBP, respectively) in tracking rapid changes in intra-operative settings compared to an invasive reference.
       
  • Pulse Wave Analysis (PWA) Techniques, Proença, M. et al., In: Solà, J., Delgado-Gonzalo, R. (eds) The Handbook of Cuffless Blood Pressure Monitoring. Springer, Cham. (2019) | DOI: 10.1007/978-3-030-24701-0_8.
    This book chapter reviews PWA principles, waveform features and indices, tonometric and PPG approaches, clinical applications and studies, and provides an outlook on PWA-based BP.