Assessment of Carotid Arterial Stiffness in Community Settings With ARTSENS®

Objective: We investigate the field feasibility of carotid stiffness measurement using ARTSENS® 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 (
$\text{E}_{\text {p}}$
), 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
$\sim 80$
% of arterial diameter values. The average RDs for
$\beta $
,
$\text{E}_{\text {p}}$
, 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,
$\text{E}_{\text {p}}$
: 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 $
,
$\text{E}_{\text {p}}$
, 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
$\text{E}_{\text {p}} \ge93.71$
kPa and/or PWV
$_{\beta } \ge6.56$
ms
⁻¹
was ≥ 2.12 or above in males. In females, it was just above 2.00 for
$\text{E}_{\text {p}} \ge91.21$
kPa and/or PWV
$_{\beta } \ge5.10$
ms
⁻¹
and increased to ≥ 3.33 for
$\text{E}_{\text {p}} \ge143.50$
kPa and ≥ 3.25 for PWV
$_{\beta } \ge7.31$
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.