The Microsoft Research Aurora Project: Important Findings on Cuffless Blood Pressure Measurement

Hypertension. 2023 Mar;80(3):534-540. doi: 10.1161/HYPERTENSIONAHA.122.20410. Epub 2022 Dec 2.


Conventional blood pressure (BP) measurement devices based on an inflatable cuff only provide a narrow view of the continuous BP profile. Cuffless BP measuring technologies could permit numerous BP readings throughout daily life and thereby considerably improve the assessment and management of hypertension. Several wearable cuffless BP devices based on pulse wave analysis (applied to a photoplethysmography or tonometry waveform) with or without use of pulse arrival time are now available on the market. The key question is: Can these devices provide accurate measurement of BP? Microsoft Research recently published a complex article describing perhaps the most important and highest resource project to date (Aurora Project) on assessing the accuracy of several pulse wave analysis and pulse wave analysis-pulse arrival time devices. The overall results from 1125 participants were clear-cut negative. The present article motivates and describes emerging cuffless BP devices and then summarizes the Aurora Project. The study methodology and findings are next discussed in the context of regulatory-cleared devices, physiology, and related studies, and the study strengths and limitations are pinpointed thereafter. Finally, the implications of the Aurora Project are briefly stated and recommendations for future work are offered to finally realize the considerable potential of cuffless BP measurement in health care.

Keywords: blood pressure determination; calibration; cuffless; pulse arrival time; pulse wave analysis; validation study; wearable electronic devices.

Publication types

  • Review
  • Research Support, N.I.H., Extramural

MeSH terms

  • Blood Pressure / physiology
  • Blood Pressure Determination* / methods
  • Heart Rate
  • Humans
  • Hypertension* / diagnosis
  • Pulse Wave Analysis / methods
  • Sphygmomanometers