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Assessing hemodynamics from the photoplethysmogram to gain insights into vascular age: a review from VascAgeNet

Lookup NU author(s): Professor John Allen



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


The photoplethysmogram (PPG) signal is widely measured by clinical and consumer devices, and it is emerging as a potential tool for assessing vascular age. The shape and timing of the PPG pulse wave are both influenced by normal vascular aging, changes in arterial stiffness and blood pressure, and atherosclerosis. This review summarizes research into assessing vascular age from the PPG. Three categories of approaches are described: 1) those which use a single PPG signal (based on pulse wave analysis), 2) those which use multiple PPG signals (such as pulse transit time measurement), and 3) those which use PPG and other signals (such as pulse arrival time measurement). Evidence is then presented on the performance, repeatability and reproducibility, and clinical utility of PPG-derived parameters of vascular age. Finally, the review outlines key directions for future research to realize the full potential of photoplethysmography for assessing vascular age.

Publication metadata

Author(s): Charlton PH, Paliakaite B, Pilt K, Bachler M, Zanelli S, Kulin D, Allen J, Hallab M, Bianchini E, Mayer CC, Terentes-Printzios D, Dittrich V, Hametner B, Veerasingam D, Zikic D, Marozas V

Publication type: Review

Publication status: Published

Journal: American journal of physiology. Heart and circulatory physiology

Year: 2022

Volume: 322

Issue: 4

Pages: H493-H522

Print publication date: 01/04/2022

Online publication date: 02/03/2022

Acceptance date: 21/12/2021

ISSN (print): 0363-6135

ISSN (electronic): 1522-1539

Publisher: American Physiological Society


DOI: 10.1152/ajpheart.00392.2021

PubMed id: 34951543