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The CardioCheck™ (also known as Pulse Trace 1000) is a portable device that allows non-invasive measurement of arterial stiffness and vascular tone.  Both of these are now recognised as markers for cardiovascular disease risk.
The CardioCheck™ uses an infra-red beam to measure in a finger, the changes in blood volume caused by the pulse.  It then compares features of the main pulse with the reflected pulse, which occurs as a result of narrowing of the arteries in the lower body. The measuring device is called a photoplethysmograph and attaches simply to any finger via a non-invasive clip-on finger cuff. Readings are taken over a short period, normally 10 or 15 seconds, and two statistics are calculated via algorithms within the hand-held recording device, which in turn can be linked to a computer for downloading data.

The two key statistics given by the device are the Stiffness Index (SI) and the Reflection Index (RI). In addition, the device gives an estimate of vascular age, measures heart rate and also allows blood pressure readings to be entered and stored. The Stiffness Index correlates with the 'gold standard' measurement for arterial stiffness. Pulse Wave Velocity (PWV) is a function of the time between the primary and reflected pulses, divided by the subject height. The Reflection Index is based on the proportional heights of the primary and reflected peaks.

In essence, a high SI means stiff arteries; stiff arteries develop with age and are a key determinant of cardiovascular disease risk. Basically, stiff arteries, akin to a copper tube, cause the reflected pulse to be returned very quickly, while more elastic arteries, as per a soft rubber hose, absorb more energy and cause a greater delay between the primary and reflected pulses. CardioCheck™ compares the SI with an existing database stored on the device to give an estimate of Vascular Age, i.e. the average age of a healthy population with the given SI (including 95% Confidence Limits).
This is the statistic that will cause most people to respond, particularly if their readings are less than ideal. So, if a patient/client is 40 years old and is told they have the arterial age of a 60-year-old, the chances are they will want to respond by implementing lifestyle and dietary changes to help reduce their risk of a cardiovascular event. They might hope that the next time a reading is taken a few weeks later - that they had managed to improve their reading. In this way, the device can act as a very effective motivator to ensure compliance with multi-factorial solutions provided by practitioners.

The RI, on the other hand, is an indicator of vascular tone and can give a very good measure of endothelial function, or dysfunction, which in turn is an important indicator of inflammation associated with early symptoms of atherosclerosis, the most common form of cardiovascular disease.

Together, these indices provide a great insight to the cardiovascular health of an individual. To-date, the only way of obtaining such measurements is via expensive hospital-based equipment that either uses invasive probes or ultrasound. Neither type of equipment is suitable for routine screening purposes and both are dependent on highly trained technicians. CardioCheck™ on the other hand, is simple to use, non-invasive and can be used by any practitioner after only a few minutes of training. Results are provided immediately. Use of CardioCheck™ is also much more immediate, simpler to interpret and potentially more meaningful than functional tests which may include blood tests for cholesterol, triglycerides, homocysteine or C-Reactive Protein. With CardioCheck™ you don’t have to wait for the lab results to come in!

What is the credibility of CardioCheck™?

One of the fascinating aspects about CardioCheck™ is that it has emerged from evidence-based science and mainstream medicine.  It is manufactured by a highly reputable UK company called Micro-Medical (Care Fusion), which produces medical devices to hospitals and clinics worldwide. CardioCheck™is the version for GP surgeries and health screening practitioners.

What about accuracy and reproducibility of results?

The device does not need to be calibrated, it is taking a direct measurement of blood volume from the finger which it then converts to pressure reading via an algorithm. A number of published studies demonstrate that the reproducibility of results from CardioCheck™, or the coefficient of variation, is equivalent or better than established devices for measuring arterial stiffness.

The science behind CardioCheck™ is exemplary. It has been led for several years by Professor Philip Chowienczyk and Dr Sandrine Millasseau from the Department of Clinical Pharmacology, St. Thomas' Hospital and others from the Centre for Cardiovascular Biology and Medicine, King's College London. The work leading to the commercialisation of the device has been extensively published in leading peer review journals, including Clinical Science, Journal of the American College of Cardiology (JACC), Cardiology and Hypertension.

The CardioCheck™ is approved by the Medicines and Healthcare Products Regulatory Agency in the UK.

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