How to Measure Arterial Stiffness in Humans

Abstract

Despite the wide recognition of larger artery stiffness as a highly clinically relevant and independent prognostic biomarker, it has yet be incorporated into routine clinical practice and to take a more prominent position in clinical guidelines. An important reason may be the plethora of methods and devices claiming to measure arterial stiffness in humans. This brief review provides a concise overview of methods in use, indicating strengths and weaknesses. We classified and graded methods, highly weighing their scrutiny and purity in quantifying arterial stiffness, rather than focusing on their ease of application or the level at which methods have demonstrated their prognostic and diagnostic potential.

Keywords: aorta; arterioles; collagen; homeostasis; prognosis.

Figure 1.

Top panel displays the typical non-linear relation between luminal pressure and area in large elastic arteries, explained by the progressive shift in load bearing from elastin to collagen fibers. Data translates into distensibility and PWV with the use of the Bramwell-Hill relation. Distensibility decreases with increasing pressure with concomitant increase in PWV. The grey shaded area indicates the physiological pressure range.

Figure 2:

Visual overview of (the concept of) methods to assess larger artery stiffness discussed in this mini-review. The top row addresses methods aiming to measure PWV, classified as direct and indirect (from a single cuff recoding). The background and label color scale ranges from green (clear phenotype) to red (unclear phenotype) to indicate the author’s qualification of methods, the arrow pointing in the direction of level of recommendation. The bottom row includes methods to assess local stiffness or local pulse wave velocity from a single site recording, using the same background color scale and arrow. The figure displays figure panels adapted from , and . See Table 1 for accompanying text.