Blood pressure refers to the exertion of force exerted by the circulating blood on the arterial walls within the human body. Arterial pressure is called blood pressure [1,2]. Early medical practitioners initially observed the correlation between blood pressure and heartbeat. The measurement of blood pressure involves the calculation of both systolic and diastolic pressures. In cardiovascular physiology, systolic pressure is typically determined during cardiac contraction, while diastolic pressure is ascertained during cardiac relaxation [1]. Heart attacks, strokes and other cardiovascular illnesses are thought to be greatly influenced by hypertension. Blood pressure readings are taken as the first step in treating hypertension. Two distinct methodologies exist for assessing blood pressure: direct and indirect. Due to its intrusive nature, only a singular method for acquiring a direct measurement exists. The direct intra-arterial measurement is achieved through the utilization of a catheter. Consequently, employing the direct technique to obtain numerous measurements is impracticable [3]. Additionally, it is among the crucial physiological parameters that aid in detecting numerous cardiovascular disorders [4]. The major goal is to provide a framework for people with chronic illnesses. Then, two components are being developed: the first is an Arduino pressure measurement device and the second is a mobile application that enables the collection and processing of vital signs for patients with high blood pressure (hypertension). A list of items to eat, warnings and recommendations based on the ranges of measured values are all possible with this app. It also shows historical data and trends for the recorded measurements.    

In recent years, there has been a growth worldwide in the usage of smart device technology in health. Numerous earlier studies have been reviewed, such as:

• Jorge Gómez uses the current patient monitoring system approach to create an architecture based on an ontology that can track patient suggestions for exercise routines and overall health [5]

• To complete the design of the hardware circuit and related  software  program for the sensor nodes, the 

coordinator node was proposed in 2015 by Lihua Zhou and Qing Laib*, who envisioned real-time monitoring of physiological signals in hospitalised patients. The sensor nodes may collect three physiological signals (temperature, pulse and electrocardiogram), while the coordination node comprises a wireless network. In addition to the routing nodes and coordinating nodes, the acquired physiological data is also delivered to the host computer information management system [ 6]

• Alamsyah et al. developed a design that can effectively and instantly monitor a patient's vital signs. An HRM-2511E type heartbeat sensor in beats per minute (bpm), a DS18b20 body temperature sensor in degrees Celsius (0C) and an MPX5700AP sensor in millimetres of mercury were used in this investigation. Medical staff can utilise this study to monitor patients' vital signs and general health. According to the proposed design's outcomes, the devices measuring blood pressure and heart rate were accurate to 97.64% and 97.53% [7]

• In 2021, Kusvihawan Muhammad Shihab created a solution for Internet of Things (IOT)-enabled measurement devices. An Arduino processes the MPX5050DP's sensor data and the Node MCU establishes a network connection to retrieve information from Firebase. Our MPX5050DP blood pressure monitoring device readings were not noticeably different from those of an Omron digital blood pressure cuff. Using the relative error equation, we find that the average time between data transfers was 13.94 seconds, or 3.83 per cent during systole and 2 per cent during diastole [ 8]

• The article by Bharat Singh offers a straightforward, affordable and user-friendly approach to blood pressure monitoring utilizing the tools of Matlab to combine the principles of the Internet of Things through an Arduino. The amount of time practitioners requires to save lives can be decreased by this system [9]

IOT (Internet of Things)

Simply as a merging of the virtual and real, various sensors and actuators make connectivity between the digital and physical realms possible. IOT devices have integrated sensors, actuators, central processing units and transceivers to achieve this level of intelligence and connection. The Internet of Things (IOT) is not a single technology but a collection of technologies that work together [10].

Blood Pressure Sensor

It is a device used to measure arterial blood pressure while the heart pumps blood throughout the body. Blood is pushed through the arterial system when our hearts beat and distributed throughout the body. This pressure is exerted on the arterial system. The blood pressure reading is the sum of the systolic pressure (measured during a heartbeat) and the diastolic pressure (measured during a resting heartbeat) [11].

Arduino

An Arduino refers to a physical measure demonstration that is open-source and based on a board with a directly connected microcontroller and a better environment for developing software for the board. Programmers can create and build devices that interact with the physical environment using an Arduino hardware development board. The numerous devices connect and communicate with it. It has several inputs, including switches, power supplies, sensors and outputs that control numerous devices, including illumination. The Arduino can be used for projects by itself or with other software packages that connect it to the computer [12]. The Arduino WiFi Shield connects Arduino to the internet wirelessly.

Node-MCU with WiFi

The software package relies on the IoT and is freely available to the public. The Espressif Systems WiFi System-on-a-Chip (SoC) ESP8266 is preloaded with firmware. The HC-05 Bluetooth Module and Related Technology.

Remote XY

Remote XY is an application making a custom graphical user interface for a microcontroller device like an Arduino via a mobile application that is simple to use remotely. The apparatus consists of [13]. Editor for controller board graphics for mobile devices 2. The mobile app remotely enables connection to the device's controller and graphical interface control.

Monitoring

Monitoring is the process of keeping track of and evaluating progress. Therefore, monitoring hypertension means monitoring and evaluating the patient's progress. As complications from high blood pressure readings may occur without the proper care, monitoring high blood pressure is necessary. Medical professionals or patients can avoid potentially dangerous situations like heart failure or stroke by monitoring their blood pressure.

Proposal Monitoring System

The IOT approaches are a prerequisite for the suggested system design in medical healthcare systems. The proposed system contains three stages, as a Figure 1.

• First Stage: Making a simple gadget with a blood pressure sensor and attaching it to the Arduino platform in the first step allows the patient's blood pressure to be measured by touching his hand on the sensor

• Second Stage: The patient's blood pressure and temperature readings are stored. The Remote XY application is used here to display the BP reading. Then they are uploaded to the doctor's smartphone or health centre via a remote application. This stage, without requiring specific programs or software in a web browser

• Third Stage: use the interface of the mobile application Remote XY for a doctor to monitor the patient's blood pressure and temperature

Figure1: Proposal for Remote Monitoring System

There are three ways to display the data, either in the form of a graph or in a digital format. In this drawing, the level of danger will be determined and the colour will change according to the level of danger. Remote XY allows: To manage microcontroller devices using your smartphone or tablet with the graphical interface. For this, management used the mobile application Remote XY.

Steps of Hardware Work

Arduino with Blood Pressure Sensor: Connecting a blood pressure sensor to an Arduino or microcontroller equipped with UART is simple. In this case, the Arduino microcontroller is set to communicate at 9600 bauds. To the circuit schematic diagram below, the sensor is connected to Arduino. Do not connect the Arduino's Rx pin to the sensor module's TX pin while dumping the code. Both of these pins are connected once the code has been spilt. Module. Both pins are connected after the code is dumped, as shown in Figure 2.

Figure 2: Connect Arduino and Blood Pressure Sensor

Connect the ESP8266 to Arduino

WiFi remote control has been added as a new feature. Support for the ESP8266 module's access point mode is the main addition. A direct connection to an access point is possible with your mobile device. The communication range may be greatly expanded compared to the Bluetooth module using ESP8266 as a WiFi access point. As the graphic above shows, neither access point mode nor Bluetooth requires a preexisting network or the Internet to function 3.

Steps of Software Work

Create Graphical interface: First, open the Remote XY editor and find the button element on the left toolbar as a Figure 4.

Figure 3: Connect Arduino and ESP8266

Figure 4: Graphical Interface

Select the following settings and click the Apply button:

• Connection: WiFi access point

• Board: Arduino UNO

• Module: ESP8266 Wi-Fi module

• IDE: Arduino IDE

The Result Using Arduino

This device uses an Arduino and a wireless connection to monitor the temperature and blood pressure on the PC screen. This entire system also needs patients who can move around. Additional parameters can be added if necessary.

It employs a BMP180 pressure sensor. The air pressure inside the housing is altered due to the vibrations, which travel via the air tube. The measurements are converted into electrical signals by the pressure sensor. The sensor itself calibrates the pressure value to mmHg units. This number represents the systolic blood pressure. The Node MCU receives this measurement. Utilizing wireless technology, the BP value is displayed. 

An ESP8266 module is utilized for interoperability. The ESP8266 module is used here for network communication. Once the value is uploaded to the microcontroller, the ESP8266 module uses serial communication to send the data to the device (phone, tablet, computer, etc.) that displays the blood pressure measurements. The ESP8266-12E chip provides wireless communication systems WiFi functionality in Node MCU. The Node MCU may connect to an already-established wireless network or be its wireless access point (hotspot). In both cases, the WiFi chip will show a different IP address. 

Table 1: Result of Measure of Blood Pressure

Devices on the same network as the Node MCU, or devices connected through the ESP8266-12E's network connection, can use the IP address. When using Arduino to measure blood pressure with Remote XY, the result showed in a doctor's smart device if the reading is up to 50, which means the blood pressure is high, while if the reading is less than 50, the blood pressure is low. The mobile of a doctor showed in Figure 5.

Figure 5: The Result of Sending Data

Figure 6: The Result of Measuring the Blood Pressure

This system demonstrates reduced energy consumption and can be employed with remote patients. The primary distinguishing feature of this study is the utilization of real-time monitoring of bio-signals. The requisite hardware and software required for the implementation of the proposed system. The Arduino platform has the potential to facilitate the development of a diverse range of uncomplicated medical devices that empower patients to acquire precise measurements of their blood pressure. This study presents a method that is both simple and economical for the monitoring of blood pressure. The proposed system integrates Arduino microcontrollers, pressure blood sensors and the Internet of Things (IOT) technology. The system operates with relatively low power consumption. In order to complete the test, it is imperative that either the tablet or smartphone is adequately charged. The aforementioned attributes can be attributed to the system, as it is characterized by simplicity, efficiency, accuracy, efficacy and robust security measures.

1. Lopez, Santiago. Blood Pressure Monitor Fundamentals and Design. Application Note by Freescale Semiconductor, 2012.

2. Rahman, Jasa Abdul. Design of Portable Blood Pressure Monitor. Bachelor Thesis, Universiti Teknologi PETRONAS, Bandar Seri Iskandar, 2007.

3. Kasper, D.L. et al. Harrison’s Principles of Internal Medicine. McGraw-Hill, New York, 2015.

4. IQWiG (Institute for Quality and Efficiency in Health Care). “High Blood Pressure.” U.S. National Library of Medicine, https://www.ncbi.nlm.nih.gov/books/NBK279251/.

5. Gómeza, Jorge et al. “Patient monitoring system based on internet of things.” Peer-Review under the Responsibility of the Conference Program Chairs, 2016.

6. Zhoua, Lihua and Qing Laib. “Design and implementation of remote health monitoring sensor network based on the internet of things.” International Conference on Industrial Electronics and Applications (IEA), 2015.

7. Alamsyah, M. et al. “Internet of things–based vital sign monitoring system.” International Journal of Electrical and Computer Engineering (IJECE), vol. 10, no. 6, 2020, pp. 5891–5898.

8. Kusvihawan, Muhammad Shihab et al. “Design and implementation of IOT-based blood pressure monitoring tools.” International Journal of Simulation: Systems, Science and Technology, vol. 21, no. 1, 2021, https://doi.org/10.5013/IJSSST.a.21.01.03.

9. Singh, Bharat et al. “Blood pressure monitoring system using wireless technologies.” International Conference on Pervasive Computing Advances and Applications – PerCAA, Procedia Computer Science, vol. 152, 2019, pp. 267–273.

10. Noordin, Aminurrashid. Cuff-less Blood Pressure Meter. Master Thesis, Universiti Teknologi Malaysia, Skudai, 2009.

11. Vignesh, P. and E. Sathya. “Bluetooth based patient monitoring system.” International Journal of Science and Research (IJSR), 2012, ISSN (Online): 2319-7064. https://www.application-datasheet.com/pdf/bosch-sensortec/521993/bma180.html.

12. Abdullah, Amna et al. “Real-time wireless health monitoring application using mobile devices.” International Journal of Computer Networks and Communications (IJCNC), vol. 7, no. 3, 2015.

13. Laurent, P. Blood Pressure and Hypertension., 2011. http://www.blood-pressure-hypertension.com/how-to-measure/measure-blood-pressure-8.shtm.