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Determinants of Cardio-Ankle Vascular Index and Heart-Thigh β Index in the MESA
Hamed Tavolinejad1,2, Kevin E Boczar3, Bart Spronck4
1Division of Cardiovascular Medicine, Hospital of the University of Pennsylvania, Philadelphia (H.T., H.M., J.A.C.).
Insights
Cardio-ankle vascular index (CAVI) and heart-thigh β index (htβ) assess arterial stiffness. Older age and male sex are linked to higher CAVI and htβ, with established normative values found in US adults.
Area of Science:
- Cardiovascular Health
- Biomarkers
- Vascular Biology
Background:
- Arterial stiffness is a key indicator of cardiovascular health.
- The cardio-ankle vascular index (CAVI) and heart-thigh β index (htβ) are emerging markers for arterial stiffness.
- Current data on normative values and determinants of CAVI and htβ in US populations are limited.
Purpose of the Study:
- To determine the factors influencing CAVI and htβ.
- To establish normative values for CAVI and htβ in a multiethnic US community-based population.
- To explore the association between these arterial stiffness markers and cardiovascular risk.
Main Methods:
- Utilized data from 2950 participants in the Multi-Ethnic Study of Atherosclerosis (MESA).
- Assessed determinants of CAVI and htβ using multivariable linear regressions.
- Defined normative values from a subgroup (N=676) excluding individuals with pre-existing cardiovascular conditions or risk factors.
Main Results:
- Older age and male sex were significantly associated with higher CAVI and htβ.
- Elevated blood pressure, height, and diabetes correlated with increased arterial stiffness indices.
- Normative values were established: mean CAVI of 8.7 and mean htβ of 8.9.
- Higher CAVI and htβ correlated with increased predicted 10-year cardiovascular risk in participants without prior cardiovascular disease.
Conclusions:
- This study provides crucial determinants and normative values for CAVI and htβ in a diverse US population.
- Findings highlight the association of these arterial stiffness markers with cardiovascular risk factors and future risk.
- Further research is warranted to elucidate the prognostic significance of CAVI and htβ.
Background:
The cardio-ankle vascular index (CAVI) and heart-thigh β index (htβ) assess arterial stiffness by correcting pulse wave velocity for blood pressure to achieve less dependency on blood pressure variations. Normative data for these markers among US communities are lacking. We aimed to assess the determinants and normative values of CAVI and htβ.
Methods:
MESA (Multi-Ethnic Study of Atherosclerosis) participants with CAVI and htβ measurements were included (N=2950). A subgroup selected to define normative values included only participants without previous cardiovascular disease, diabetes, smoking, antihypertensive use, and with blood pressure <140/90 mm Hg, body mass index <35 kg/m2, and creatinine <1.5 mg/dL. Associations were assessed by multivariable linear regressions. All continuous variables were standardized.
Results:
Among 2950 participants (mean age, 73.6 years; 47.2% male), older age (β for CAVI=0.39, P<0.001 and htβ=0.41, P<0.001), and male sex (β for CAVI=0.30, P<0.001 and htβ=0.11, P<0.001) were associated with higher arterial indices. Participants with higher blood pressure, height, and diabetes exhibited higher CAVI and htβ. A higher waist circumference was associated with lower CAVI and htβ. Among the normative value subgroup (N=676), the mean CAVI was 8.7 (2 Z score range, 6.5-11.2), and the mean htβ was 8.9 (2 Z score range, 4.3-13.6). Among participants without cardiovascular disease, higher CAVI and htβ were associated with higher predicted 10-year cardiovascular risk estimated by pooled cohort equations (per SD of CAVI=3.6%, P<0.001 and htβ=3.3%, P<0.001).
Conclusions:
We report determinants and normative values of CAVI and htβ in a multiethnic community-based US population. Future studies should focus on the prognostic utility of CAVI and htβ.
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