Background: Blood pressure (BP) is an essential indicator for human health and is known to be greatly influenced by lifestyle factors, like activity and sleep factors. However, the degree of impact of each lifestyle factor on BP is unknown and may vary between individuals. Our goal is to investigate the relationships between BP and lifestyle factors and provide personalized and precise recommendations to improve BP, as opposed to the current practice of general lifestyle recommendations. Method: Our proposed system consists of automated data collection using home BP monitors and wearable activity trackers and feature engineering techniques to address time-series data and enhance interpretability. We propose Random Forest with Shapley-Value-based Feature Selection to offer personalized BP modeling and top lifestyle factor identification, and subsequent generation of precise recommendations based on the top factors. Result: In collaboration with UC San Diego Health and Altman Clinical and Translational Research Institute, we performed a clinical study, applying our system to 25 patients with elevated BP or stage I hypertension for three consecutive months. Our study results validate our system’s ability to provide accurate personalized BP models and identify the top features which can vary greatly between individuals. We also validate the effectiveness of personalized recommendations in a randomized controlled experiment. After receiving recommendations, the subjects in the experimental group decreased their BPs by 3.8 and 2.3 for systolic and diastolic BP, compared to the decrease of 0.3 and 0.9 for the subjects without recommendations. Conclusion: The study demonstrates the potential of using wearables and machine learning to develop personalized models and precise lifestyle recommendations to improve BP.
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