Assessment of Carotid Arterial Stiffness in Community Settings With ARTSENS®

Objective: We investigate the field feasibility of carotid stiffness measurement using ARTSENS(R) Touch and report the first community-level data from India. Method: In an analytical cross-sectional survey among 1074 adults, we measured specific stiffness index (beta), pressure-strain elastic modulus (Ep), arterial compliance (AC), and one-point pulse wave velocity (PWV beta) from the left common carotid artery. Data for established risk factors (waist circumference, blood pressure, plasma glucose, triglycerides, and HDL-C) were also collected. The association of carotid stiffness with age, gender, hypertension/diabetes, smoking, and clustering of risk factors was studied. Results: Measurements were repeatable with a relative difference (RD) between consecutive readings of < 5% for blood pressure and < 15% for similar to 80% of arterial diameter values. The average RDs for beta, E-p, AC, and PWV beta, were 20.51%, 22.31%, 25.10%, and 14.13%, respectively. Typical range for stiffness indices among females and males were beta: 8.12 +/- 3.59 vs 6.51 +/- 2.78, E-p: 113.24 +/- 56.12 kPa vs 92.33 +/- 40.65 kPa, PWV beta: 6.32 +/- 1.38 ms(-1) vs 5.81 +/- 1.16 ms(-1), and AC: 0.54 +/- 0.36 mm(2) kPa(-1) vs 0.72 +/- 0.38 mm(2) kPa(-1). Mean beta, E-p, and PWV beta increased (and mean AC decreased) across decades of age; the trend persisted even after excluding hypertensives and subjects with diabetes. The odds ratio of presence of multiple risk factors for E-p >= kPa and/or PWV beta ms(-1) was = 2.12 or above in males. In females, it was just above 2.00 for E-p >= kPa and/or PWV beta ms(-1) and increased to >= 3.33 for E-p >= kPa and >= 3.25 for PWV beta ms(-1). Conclusion: The study demonstrated the feasibility of carotid stiffness measurement in a community setting. A positive association between the risk factors and carotid artery stiffness provides evidence for the device's use in resource-constrained settings. Clinical Impact: The device paves the way for epidemiological and clinical studies that are essential for establishing population-level nomograms for wide-spread use of carotid stiffness in clinical practice and field screening of 'at-risk' subjects.