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This study evaluated the reliability and validity of a cuffless method for ambulatory BP monitoring using pulse wave travel times derived from bio-impedance, impedance cardiography, and electrocardiography. We examined whether this method can accurately estimate systolic and diastolic BP cross varying conditions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Forty-one young, healthy participants completed a protocol involving postural changes, physical activity, and mental stress tasks. Pulse arrival time (PAT) and pulse transit time (PTT) were extracted, and person-specific models estimated BP using (1) all data of the person (\u2018double-dipping\u2019) \u2013 used in most previous studies \u2013, (2) half of a person\u2019s data (calibration), or (3) person-invariant parameters (calibration-free) which would enhance practical utility. Cuff-based BP served as the reference. Test-retest reliability, and construct and convergent validity were assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Test-retest reliability was high for PAT- and PTT-based BP for all approaches (ICC &gt; 0.7), comparable to cuff-based measurements. Construct validity was generally poor: BP changes during physical activity were detected, but responses to mental stressors were not. Only double-dipping showed acceptable convergent validity, likely reflecting overfitting. In the calibration approach, convergence with cuff-based BP was moderate (MAE = 10.1\u201312.9 mmHg), with 59.2\u201368.5% of estimates within 10 mmHg of reference values. The strongest deterioration of convergentvalidity occurred with person-invariant models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Although cuffless pulse wave travel time-based BP estimators showed strong reliability, validity was insufficient for clinical or stress research use, even with person-specific calibration. Future work should explore extended calibrationperiods before testing in naturalistic settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s00421-026-06404-5","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T11:32:45Z","timestamp":1790249565000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation study on cuffless ambulatory blood pressure monitoring method using bio-impedance, impedance cardiography and electrocardiography"],"prefix":"10.1007","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3458-162X","authenticated-orcid":false,"given":"Myrte","family":"Schoenmakers","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martin","family":"Gevonden","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruno","family":"Sauce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eco","family":"de Geus","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,9,24]]},"reference":[{"issue":"4","key":"6404_CR1","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1097\/HJH.0000000000003960","volume":"43","author":"TP Almeida","year":"2025","unstructured":"Almeida TP, Perruchoud D, Alexandre J, Vermare P, Sola J, Shah J, Marques L, Pellaton C (2025) Evaluation of Aktiia cuffless blood pressure monitor across 24-h, daytime, and night-time measurements versus ambulatory monitoring: A prospective, single-centre observational study. 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