Development and validation of a nomogram for arterial stiffness

Area of Science:

• Cardiovascular Health
• Preventive Medicine
• Biostatistics

Background:

• Carotid-femoral pulse wave velocity (cfPWV) is the gold standard for measuring arterial stiffness but is impractical for primary care due to time and equipment constraints.
• Arterial stiffness is a significant indicator of cardiovascular risk.
• There is a need for accessible and cost-effective screening tools for arterial stiffness in primary healthcare settings.

Purpose of the Study:

• To develop a convenient and low-cost nomogram model for screening arterial stiffness.
• To evaluate the performance and clinical utility of the developed nomogram model.

Main Methods:

• A cross-sectional study involving 2717 participants was conducted to construct the nomogram.
• Least absolute shrinkage and selection operator (LASSO) and logistic regression were used for model development.
• Model performance was assessed using ROC curves, calibration curves, decision curve analysis, and clinical impact curves, with internal and external validation.

Main Results:

• The nomogram model incorporated age, sex, waist-to-hip ratio, systolic blood pressure, diabetes duration, and heart rate.
• The model demonstrated good discrimination (AUC = 0.820) and accuracy (MAE = 0.005).
• Decision and clinical impact analyses indicated positive net benefit, with satisfactory validation results.

Conclusions:

• A user-friendly and low-cost nomogram has been developed for effective arterial stiffness screening.
• This nomogram is suitable for implementation in primary healthcare institutions.
• The model offers a practical alternative to cfPWV for identifying individuals with arterial stiffness.