Feasibility of continuous finger arterial pressure recording with synchronised facial video in a hypertension clinic cohort: the BP-WAVE pilot study

Introduction Whether the arterial pressure waveform carries structural vascular information beyond brachial pressure, and whether facial video can read its shape, are uncertain. We sought to determine whether continuous finger arterial pressure recording with synchronised facial video, linked to existing coronary calcium imaging, is feasible in a hypertension clinic, whether a consumer camera recovers heart rate and pulse shape, and the exploratory association between waveform morphology and coronary calcium. Methods BP-WAVE is a single-site prospective observational pilot study. The primary outcome was feasibility: recruitment, consent, completeness of recording, imaging availability and data completeness. Secondary outcomes were waveform quality, device agreement, feature availability and video recovery of heart rate and pulse shape. Exploratory outcomes were Spearman correlations of 14 waveform features with the Agatston calcium score, with exact permutation p values adjusted within families. Results Nine of ten planned participants were recorded over 12 days (median age 55 years, range 40 to 74; five women). Nine of 15 patients approached consented (60%, 95% CI 32.3 to 83.7%); all nine completed the recording with video and had a calcium score (median 351, range 33 to 1816). Of 4,178 detected beats, 2,965 (71%) passed quality control. Video recovered heart rate within 0.4 to 4.1 beats per minute in eight of nine participants, and camera pulse shape exceeded a phase-randomised benchmark in six of nine (held-out r 0.48 to 0.76). Form factor had the strongest correlation with calcium (rho −0.75, 95% CI −0.94 to −0.17, exact p 0.025, q 0.36); no association met the Benjamini-Hochberg-adjusted significance threshold (126 tests in nine families; smallest q 0.14). Conclusion In this imaging-selected pilot of nine hypertension clinic patients, continuous finger arterial pressure recording with synchronised facial video and linkage to coronary calcium was feasible, a consumer camera recovered heart rate in eight and its pulse shape exceeded a phase-randomised benchmark in six, and no waveform-calcium association met the multiple-testing-adjusted significance threshold.