Cardio-ankle vascular index represents the best surrogate for 10-year ASCVD risk estimation in patients with primary...

Area of Science:

• Cardiology
• Vascular Biology
• Hypertension Research

Background:

• Accurate risk stratification is crucial for managing hypertensive and hyperlipidaemic patients at intermediate risk.
• Identifying target organ damage and risk-enhancing factors aids treatment decisions.
• 10-year atherosclerotic cardiovascular disease (ASCVD) risk estimates guide clinical management.

Purpose of the Study:

• To compare the efficacy of various hypertension-mediated organ damage (HMOD) markers in predicting 10-year ASCVD risk (≥10%).
• To evaluate HMOD markers in asymptomatic patients with primary hypertension but without established cardiovascular disease (CVD).

Main Methods:

• 137 asymptomatic hypertensive patients aged ≥40 years were enrolled.
• 10-year ASCVD risk was calculated using Pooled Cohort Equations.
• Efficacy of HMOD markers (pulse pressure, LVMI, CIMT, ABI, CAVI, eGFR) was assessed using ROC analysis.

Main Results:

• Cardio-ankle vascular index (CAVI) demonstrated the highest Area Under the Curve (AUC=0.736), followed by carotid intima-media thickness (CIMT, AUC=0.727).
• Left ventricular mass index (LVMI) and pulse pressure (PP) showed moderate predictive value.
• Ankle-brachial index (ABI) and estimated glomerular filtration rate (eGFR) were not predictive.
• CAVI showed the strongest correlation with estimated 10-year ASCVD risk (r=0.460) and optimal sensitivity/specificity (71%/72%) for risk ≥10%.

Conclusions:

• Cardio-ankle vascular index (CAVI) is the most effective surrogate marker for predicting 10-year ASCVD risk among the evaluated HMOD markers.
• CAVI provides a graded response to increasing ASCVD risk categories.
• These findings support the utility of CAVI in refining cardiovascular risk assessment in hypertensive individuals.