From PPG to Blood Pressure at the Edge: Quantization-Aware Architecture Selection and On-MCU Validation

Blood pressure is a central marker of cardiovascular risk, but continuous monitoring remains difficult because cuff-based measurements are intermittent and uncomfortable. Photoplethysmography (PPG) is already ubiquitous in wearables and can, in principle, enable cuffless blood pressure estimation from a single optical signal. However, many deep learning approaches that perform well in floating-point are impractical for microcontroller-class devices, where memory budgets, latency, and integer-only arithmetic constrain what can be deployed. A key open question is which neural architectures retain accuracy after full-integer quantization, rather than only under desktop inference. Here, we show an end-to-end, microcontroller-oriented evaluation framework that benchmarks multiple 1D convolutional models for cuffless systolic and diastolic pressure estimation from single-channel PPG, jointly optimizing estimation error, model footprint, and quantization robustness. We find that floating-point accuracy alone is a poor predictor of deployability: some lightweight CNNs exhibit substantial performance drift after INT8 conversion, whereas a compact residual 1D CNN preserves its predictions with near-identical error statistics after integer quantization. We then deploy the selected integer-only model on an STM32N6 microcontroller using an industrial toolchain and confirm that on-device inference maintains low bias and limited error dispersion while meeting real-time constraints for continuous operation. These results highlight architecture-dependent quantization stability as a critical design dimension for sensor-edge intelligence and support the feasibility of fully on-device cuffless blood pressure monitoring without multimodal sensing or cloud processing.