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Updated: Sep 14, 2025

Measuring the Carotid to Femoral Pulse Wave Velocity Cf-PWV to Evaluate Arterial Stiffness
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Hidden Cardiovascular Risk: Arterial Stiffness and Left Ventricular Remodeling as Potential Indicators of Masked

Chengjie Zhu1, Yanna Lei1, Vipin Kumar2

  • 1Intensive Care Unit, Yanbian University Hospital, Yanji, Jilin, P.R. China.

Journal of Clinical Hypertension (Greenwich, Conn.)
|July 21, 2025
PubMed

Insights

Masked hypertension (MH), a condition with normal office blood pressure but high out-of-office readings, poses significant cardiovascular risks. Early detection using cardiac-ankle vascular index (CAVI) and cardiac assessments can identify at-risk individuals.

Area of Science:

  • Cardiology
  • Vascular Medicine
  • Hypertension Research

Background:

  • Masked hypertension (MH) presents normal office blood pressure (OBP) with elevated out-of-office readings.
  • MH carries cardiovascular risks similar to sustained hypertension, yet is challenging to diagnose.
  • Emerging evidence suggests combined vascular and cardiac assessments can aid MH detection.

Purpose of the Study:

  • To review evidence on screening for masked hypertension.
  • To highlight the utility of combined vascular and cardiac assessments for MH detection.
  • To propose a screening strategy for earlier MH identification.

Main Methods:

  • Review of emerging evidence on masked hypertension screening.
  • Analysis of findings from the PAMELA study on combined vascular and cardiac assessments.
  • Evaluation of cardiac-ankle vascular index (CAVI) as a screening parameter.

Main Results:

  • Patients with elevated CAVI and left ventricular hypertrophy (LVH) or concentric remodeling showed a 2.3-fold increased risk of MH.
  • This association was particularly noted in men and was independent of age and antihypertensive treatment.
  • CAVI demonstrated advantages in screening due to measurement stability and prognostic value.

Conclusions:

  • A stepwise screening approach using CAVI followed by echocardiography may facilitate earlier MH detection in at-risk patients.
  • Timely intervention based on early MH detection can potentially reduce cardiovascular morbidity and mortality.
  • Further validation and cost-effectiveness analyses are needed for the proposed screening strategy.

Keywords:
arterial stiffnesscardio‐ankle vascular indexleft ventricular remodelingmasked hypertension

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