Longitudinal Associations Between Metabolic Risk Burden and the Cardio-Ankle Vascular Index (CAVI) in Japan Using
Yuzo Horibuchi1, Larbi Aluariachy2, Reiko Yamaura1
1Graduate School of Medicine, International University of Health and Welfare, Tokyo, Japan.
Insights
Arterial stiffness, measured by cardio-ankle vascular index (CAVI), is linked to metabolic risks. Blood pressure and glucose abnormalities most strongly predict CAVI, highlighting its value in assessing vascular health beyond waist circumference.
Area of Science:
- Cardiology
- Vascular Health
- Metabolic Syndrome
Background:
- Cardio-ankle vascular index (CAVI) is a blood pressure-independent marker of arterial stiffness.
- Limited longitudinal data exist on the relative impact of metabolic risk factors on CAVI progression.
Purpose of the Study:
- To investigate the longitudinal associations between metabolic abnormalities and CAVI in a Japanese population.
- To focus on metabolic syndrome (MetS) components and waist circumference (WC) status.
Main Methods:
- Included 13,724 adults undergoing annual health check-ups.
- Utilized linear mixed-effects models to assess longitudinal CAVI changes based on MetS components (blood pressure, glucose, lipids, WC).
- Conducted secondary analyses by MetS status, WC strata, metabolic risk count, and sex.
Main Results:
- Older age and male sex were associated with higher CAVI.
- Blood pressure and glucose abnormalities showed the strongest link to elevated CAVI; lipids had a modest effect, and WC was inversely associated.
- CAVI increased annually, but slower in those with blood pressure risk; baseline CAVI indicated cumulative vascular injury.
Conclusions:
- Blood pressure and glucose abnormalities are key drivers of longitudinal CAVI changes.
- CAVI can identify individuals, particularly non-obese women, with elevated vascular risk, complementing waist circumference screening.
Purpose:
The cardio-ankle vascular index (CAVI) is a blood pressure-independent indicator of arterial stiffness. Although CAVI is associated with metabolic risk factors, longitudinal evidence clarifying their relative impact remains limited. This study aimed to examine longitudinal associations between metabolic abnormalities and CAVI in a Japanese health check-up population, focusing on MetS components and waist circumference (WC) status.
Patients And Methods:
A total of 13,724 adults (7060 men and 6664 women) who underwent annual health check-ups at the International University of Health and Welfare Narita Hospital between 2020 and 2024 were included. Linear mixed-effects models were used to evaluate longitudinal changes in CAVI according to MetS components (blood pressure, glucose, lipids, and WC). Secondary analyses examined CAVI changes by MetS status, WC strata (WC (+)/WC (-)), metabolic risk count (0-3) and sex.
Results:
Older age and male sex were independently associated with higher CAVI. Blood pressure and glucose abnormalities showed the strongest associations with elevated CAVI, whereas lipid risk had a modest effect and WC was inversely associated with CAVI. CAVI increased annually overall, but increased more slowly among participants with blood pressure risk. Time interactions for glucose, lipid and WC risk were not significant. MetS was associated with higher baseline CAVI, but longitudinal time interactions did not differ significantly by MetS status. In WC-stratified analyses, baseline CAVI increased stepwise with accumulation of metabolic risk factors in both WC (+) and WC (-) groups, including a substantial WC (-)-subgroup-particularly women-with multiple metabolic risks and elevated CAVI.
Conclusion:
Longitudinal follow-up revealed modest CAVI progression with attenuated slopes among participants with high-baseline CAVI, indicating that baseline CAVI captures cumulative vascular injury rather than accelerated short-term change. CAVI may complement WC-centered screening by identifying non-obese individuals-especially women-with elevated longitudinal vascular risk.
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