Increasing carotid stiffness is associated with an ascending atherosclerotic risk and cardiovascular events. Therefore early risk detection can prevent stroke and myocardial infarction

We analyzed ultrasound clips of average strain over a standardized 1cm-segment over at least one heart cycle in 1929 participants of the SAPALDIA3 cohort study (mean 62.4(8.2) years, range 50–81 years, 41.2% men). Strain was defined as cyclic deformation of lumen diameter expressed in percent change. Furthermore we assessed the risk of cardiovascular disease with the European Systematic Coronary Risk Evaluation (SCORE) based on data from SAPALDIA2 in 2002 and divided the SCORE into three categories (G1: risk of 1% or less, G2: risk of 2 to 4%, G3: risk of more than 5%). The association between strain and this categorical risk measure was assessed using multiple linear regressions, with and without additional adjustment for sex, age and brachial pulse pressure (PP). Results are expressed as adjusted means with 95%-confidence intervals.

Mean strain was 7.22(7.13, 7.31) in G1, 6.43(6.31, 6.55) in G2 and 5.64(5.39, 5.89) in G3, these differences being statistically significant (p<0.001). The difference still existed when strain was adjusted for current PP (G1: 7.27(7.17, 7.36), G2: 6.34(6.21, 6.46), G3: 5.41(5.14, 5.67)) or sex (G1: 7.24(7.14, 7.33), G2: 6.39(6.26, 6.52), G3: 5.54(5.27, 5.80)). After adjustment for age (G1: 6.97(6.88, 7.07), G2: 6.91(6.77 7.05), G3: 6.85(6.55 7.16)) there was no significance between the different risk groups anymore.

The present data suggest that prior risk assessment can predict strain, but current age seems to be a stronger predictor.