Dual-impedance cardiography for the assessment of arterial stiffness: Associations with blood pressure, cardiometabolic risk factors, and preclinical atherosclerosis in midlife adults

PurposePulse wave velocity (PWV) is a measure of arterial stiffness that reflects vascular aging and predicts risk for cardiovascular disease. We developed a PWV measurement method that uses dual-impedance cardiography (d-ICG) to address limitations of other common methods (e.g., ultrasound, tonometry, etc.), as well as to enable PWV assessments across a broader range of populations. This pre-registered, cross-sectional study tested for the first time the extent to which d-ICG PWV associates with cardiometabolic risk factors (i.e., blood pressure and other metabolic syndrome components) and vascular markers of preclinical atherosclerosis (i.e., carotid-artery intima-media thickness [C-IMT] and plaque).MethodsParticipants were 366 otherwise healthy adults (aged 28-57; 63.4% female). In a subsample (N = 179), estimates of d-ICG PWV were compared for the first time against carotid-femoral PWV (cfPWV) measured by a Complior device.Resultsd-ICG PWV and cfPWV measures were comparably associated with age and blood pressure (r's ≥ .28, p's ≤ .001), and they exhibited moderate consistency (ICCs = 0.51 to 0.55, p's < .001). Across all cardiometabolic risk factors and markers of preclinical atherosclerosis, there were no clinically meaningful differences in the average composite (Fisher's Z-score) correlations with arterial stiffness measured by d-ICG and cfPWV based on Cohen's q values (q's = 0.042 to 0.097).Conclusiond-ICG PWV may be a low-cost, reliable, and alternative method for obtaining estimates of arterial stiffness that track with cardiometabolic risk factors and preclinical atherosclerosis.