Measuring arterial stiffness, using a tool called CAVI, to predict cardiovascular risk

Measuring arterial stiffness, using a tool called CAVI, to predict cardiovascular risk
Measuring arterial stiffness, using a tool called CAVI, to predict cardiovascular risk

Nancy, France — According to a study carried out among 1250 Europeans, high arterial stiffness is linked to an increase in cardiovascular risk. The authors of this work suggest using the measurement of arterial stiffness as a tool for predicting cardiovascular risk, using a tool called CAVI (Cardio Ankle Vascular Index).[1]. Magnus Back, Inserm research director in Nancy and co-author of the study, details it to Medscape.

Arterial stiffness

As we age, the arteries become more and more rigid. This loss of flexibility can be accelerated by factors such as hypertension or diabetes and the scientific literature indicates that it is associated with increased cardiovascular risk. However, the examination of arterial stiffness is not currently among the list of recommended clinical practices.

Based on these data, researchers from Inserm, the University of Lorraine and the Nancy University Hospital looked into the benefit of studying arterial stiffness to prevent cardiovascular risk. To do this, they followed 1,250 people from 18 European countries, all aged over 40.

An index to define the flexibility of the arteries

After providing their medical history, they underwent a physical examination including an assessment of their arterial stiffness using the CAVI (Cardio Ankle Vascular Index) measurement tool. “To use it, the person being examined is placed on their back and cuffs are placed around both arms and both ankles,” explains Magnus Bäck. “A microphone is placed at the level of the heart to monitor its beats. We measure the pressures and the speed of blood circulation to the arms and ankles and an algorithm then calculates an index which allows us to define the flexibility of the arteries. The higher the index, the greater the stiffness of the arteries,” he explains.

We observed that each increase of one point in the CAVI index, i.e. an increase of approximately 10% in arterial stiffness, is associated with a 25% increased risk of occurrence of a CV event in the years following the measure
Magnus Back

Quick, non-invasive tool

“This tool has several advantages: it is easy to use, fast, non-invasive and allows results to be obtained independent of blood pressure,” he adds.

The people studied were then seen for a follow-up examination two years later and, for some of them, up to 5 years after the first measurement. “This allows us to see the progression of the stiffness of the arteries and to correlate it with the general condition of the people,” underlines the researcher. Cardiovascular events were recorded in 129 participants.

“We observed that each one-point increase in the CAVI index, which corresponds to an increase of approximately 10% in arterial stiffness, was associated with a 25% increased risk of a cardiovascular event in years following the measurement,” explains Magnus Bäck.

The evolution of arterial stiffness was influenced by aging, but also by high blood pressure.

“To be able to use the CAVI index in the clinic, we determined a threshold of arterial stiffness associated with increased cardiovascular risk. Beyond the age of 60, we noted that the threshold beyond which the risk increases is 9.25. For younger people, between 40 and 60 years old, cardiovascular events are less frequent. We were also able to determine a threshold, at 8.3, but with less security,” he explains.

For him, “the CAVI index is an easy and non-invasive tool for predicting cardiovascular risk. Our study paves the way for its use among the tools used clinically in the list of recommended examinations,” believes Magnus Bäck. During their study, the researchers also observed the effects of prevention treatments on the progression of arterial stiffness. “Certain treatments could delay it, but it is too early to determine this with certainty and additional studies more targeted on this question are necessary,” he concludes.

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