Increased arterial stiffness is acknowledged as an early marker of subclinical organ damage in hypertension. Its use for risk stratification in daily practice is limited because of relative complexity of its assessment. Cardio Ankle Vascular stiffness Index (CAVI) is a recently proposed, easy to obtain, blood pressure independent index of arterial stiffness and can be used as a vascular age marker. Aim of our study was to assess the relationship between CAVI and other indices of cardiovascular organ damage in hypertension.Design and method:
In 362 consecutive essential hypertensive patients (179 M/183F;age 14–81yrs) referred to our Hypertension Clinic we performed: echocardiography, carotid ultrasound examination (both with Vivid 7, GE), CAVI measurement (VaSera Fukuda Denshi), renal function assessment (eGFR, CKD-EPI formula). CAVI was used to subdivide our subjects based on age-specific reference values in three vascular age classes, respectively higher than (HVA), corresponding to (normal, NVA) or lower than (LVA) anagraphic ageResults:
CAVI showed a direct correlation with age (R = 0.62, p < 0.001), left ventricular (LV) mass indexed for body surface area (R = 0.22;p < 0.001), LV relative wall thickness (RWT: R = 0.17; p < 0.001), carotid intima-media thickness (cIMT;R = 0.40;p < 0.001), eGFR (R = 0.38;p < 0.001)and E/e’(R = 0.23; p < 0.001). In multiple regression analysis only age (p < 0.001) was independently associated with CAVI.Results:
NVA (N = 149), HVA (N = 124) and LVA (N = 89) groups had similar clinical characteristics (NVA:77 M/72F, age 54.8yrs, heart rate 65.6bpm, HVA:59 M/65F, age55.4yrs, heart rate 67.5bpm, LVA:47 M/42F, age53.7yrs, heart rate 67. bpm, all differences NS. Significant differences emerged for office systolic blood pressure between HVA (143.5 mmHg) and LVA (137.3 mmHg), p < 0.01; and for body mass index between LVA (28.3 kg/m2) and NVA (27 kg/m2), p < 0.05.Results:
HVA group had higher LV mass index, RWT and E/e’ than NVA and LVA groups (p < 0.05). No differences in aortic dimensions and left atrium diameter were observed. The three groups showed similar cIMT and prevalence of carotid plaques (ns). Laboratory tests such as total, LDL and HDL cholesterol, glucose, microalbuminuria and eGFR were not significantly different between groupsConclusions:
Our data confirm a significant relationship of CAVI with anagraphic age and with predisposition to subclinical cardiovascular damage and indicate a strong correlation with vascular age even after correcting for all other subclinical cardiac damage markers. Our study thus supports the suggestion that CAVI may represent an easy tool for early detection of patient with high cardiovascular risk.