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The cost of health care in first-world countries is increasing dramatically as a result of advances in medicine, a population that is becoming older and an increasingly unhealthy lifestyle. Personal health care concepts where sensors within and around the body monitor and measure all kind of physiological signals can be an addition to medicare with high benefits. This concept allows patients to stay in their home environment and hence have a better quality of life with lower costs involved. For these reasons research and development is ongoing on many body worn and implantable sensor nodes. In this paper it is shown that application knowledge and understanding the contribution of different components to the system power consumption is the best starting point to make optimal trade-offs in the system design. This will minimize the overall power consumption of a sensor node without losing track of the major functionality needed. Besides the importance of system optimization, it is also shown that new components and circuit techniques need to be developed to achieve orders of magnitude increase in energy efficiency. This is a must to realize ultra-thin electrocardiogram patches as well as more demanding nodes with a small form factor like real-time Electro Encephalogram processing for brain computer interaction or neuro-implants.