Clinical Significance of the Cardio-Ankle Vascular Index (CAVI) in Hypertension

Kazuhiko      Kotani; Michiaki      Miyamoto; Nobuyuki      Taniguchi

Abstract

Increased blood pressure and hypertension are a major atherosclerotic risk factor. Arterial stiffness is recognized to be reflective to the atherosclerotic states. The pulse wave velocity (PWV) is a noninvasive, simple, easy and reproducible index that can be used to assess arterial stiffness in association with blood pressure. The cardio-ankle vascular index (CAVI) has recently been developed to evaluate arterial stiffness similarly to PWV, but theoretically, this index is less influenced by blood pressure. There have been several clinical reports on the use of the CAVI in patients with hypertension. The CAVI levels are reported to be significantly and positively correlated with the ultrasonographical atherosclerotic parameters of carotid arteries, as a surrogate marker of atherosclerotic events, in hypertensive patients. Intervention studies of anti-hypertensive therapy using CAVI have shown that candesartan, olmesartan and efonidipine can improve the CAVI levels. These results suggest that the CAVI is clinically helpful for the assessment of atherosclerotic risk and the management with drug treatment in patients with hypertension. However, compared with PWV, there is not much evidence of using CAVI in a clinical setting; future research is therefore necessary.

Keywords: Blood pressure, PWV, atherosclerosis, anti-hypertensive therapy, Cardio-Ankle Vascular Index, Hypertension, atherosclerotic risk factor, pulse wave velocity, carotid arteries, candesartan, olmesartan, efonidipine, heart disease, stroke, chronic kidney disease, diabetes, metabolic syndrome, smoking, ankle-brachial pressure, augmentation index, arterial wall thickness, calcification, arterial fluctuation, pulse waves, arterial elasticity, ischemic heart disease, atherosclerotic disease, cerebrovascular disease, arterial stiffness, Bramwell-Hill formulation, stiffness parameter, blood density, systolic BP, diastolic BP, BP component, brachial artery, heart sound, electrocar-diogram, aortic valve, chest pain syndrome, carotid ultrasonography, ventricular diastolic indices, echocardiography, serum levels, lipoprotein cho-lesterol, angina pectoris, anginal pathophysiology, telmisartan, losartan, potent affinity, binding capacity, angiotensin, amlodipine, amlodipine-treated, 8-hydroxy-2'-deoxyguanosine, oxidative stress burden, nephropathy, an-giotensin, plasma aldosterone, calcium channel, alleviation of renal, coronary heart attack, altitude, pathophysiology