BackgroundA cardio-ankle vascular index (CAVI) has been developed to represent the extent of arteriosclerosis throughout the aorta, femoral artery and tibial artery independent of blood pressure. To practically use CAVI as a diagnostic tool for determining the extent of arteriosclerosis, our study objectives were (1) to establish the baseline CAVI scores by age and gender among cardiovascular disease (CVD) risk-free persons, (2) to compare CAVI scores between genders to test the hypothesis that the extent of arteriosclerosis in men is greater than in women, and (3) to compare CAVI scores between the CVD risk-free group and the CVD high-risk group in order to test the hypothesis that the extent of arteriosclerosis in the CVD high-risk group is greater than in the CVD risk-free group.MethodsStudy subjects were 32,627 urban residents 20-74 years of age who participated in CVD screening in Japan during 2004-2006. A new device (model VaSera VS-1000) was used to measure CAVI scores. At the time of screening, CVD high-risk persons were defined as those having any clinical abnormalities of CVD, and CVD risk-free persons were defined as those without any clinical abnormalities of CVD. Age-specific average CAVI scores were compared between genders and between the CVD risk-free group and the CVD high-risk group. Student's t-test using two independent samples was applied to a comparison of means between two groups.ResultsAverage age-specific baseline scores of CAVI in the CVD risk-free group linearly increased in both genders as their age increased. Average age-specific baseline scores of CAVI in the CVD risk-free group were significantly greater among men than among women. Average age-specific baseline scores of CAVI in the CVD risk-free group were significantly smaller than those in the CVD high-risk group in both genders after 40 years of age.ConclusionsThe baseline CAVI scores from the CVD risk-free group are useful for future studies as control values. The CAVI method is a useful tool to screen persons with moderate to advanced levels of arteriosclerosis.
BackgroundDiabetes mellitus (hereafter called diabetes) is considered to accelerate arteriosclerosis leading to coronary heart disease and stroke. Thus, it is important to quantitatively estimate the extent of subclinical arteriosclerosis. A new method called cardio-ankle vascular index (CAVI) is developed to reflect arterial stiffness independently from blood pressure at the time of measurement. Then, we examined if CAVI scores could discriminate the extent of arteriosclerosis between persons with prediabetes (or borderline diabetes) and with diabetes among Japanese urban workers and their families.MethodsSubjects were 9881 men and 12033 women of company employees and their families who participated in cardiovascular disease screening in Japan. Persons having diabetes and prediabetes were defined based on the criteria set by American Diabetes Association. CAVI scores were measured by VaSera VS-1000. We applied the established age-sex specific cutoff points of CAVI scores above which were determined to be abnormally high or advanced level of arteriosclerosis. To examine the association of prediabetes and diabetes with CAVI scores, CAVI scores of screening participants were converted to a binary variable: 1 for less than cutoff points and 2 for equal or greater than cutoff points or abnormally high CAVI scores. Logistic regression method was used to examine the association of prediabetes and diabetes with CAVI scores after adjusting for major cardiovascular disease (CVD) risk factors.ResultsPrevalence of abnormally high CAVI scores was significantly higher after 40 years of age among persons with diabetes than either among persons with prediabetes or among normal persons in both genders. Significantly elevated odds ratios (ORs) of abnormally high CAVI scores appeared among persons with prediabetes: 1.29 (95 % confidence interval (CI), 1.11-1.48) for men and 1.14 (CI, 1.01-1.28) for women, and among persons with diabetes: 2.41 (CI, 1.97-2.95) for men and 2.52 (CI, 1.94-3.28) for women.ConclusionsThe extent of subclinical arteriosclerosis (including arterial stiffness and atherosclerosis) was moderately enhanced among persons with prediabetes and was further advanced among persons with diabetes. Thus, it is important to introduce earlier interventions for changing lifestyle and diet of persons with prediabetes in order to prevent them from developing diabetes and further advancing arteriosclerosis.
Purpose: Recently the cardio-ankle vascular index (CAVI) has been developed to represent the extent of arteriosclerosis in the artery from the aortic valve to the ankle. The aim of the study is to examine the association of CAVI scores with the established cardiovascular disease (CVD) risk factors and coronary heart disease (CHD). Methods: Subjects were 9,881 men and 12,033 women of company employees and their families between 20 and 70 years of age and over who participated in CVD screening in Japan. The screening included measurements of CAVI, electrocardiogram, blood pressure, lipids, serum glucose, hemoglobin A1c, height, weight, and questions on smoking and drinking status. Persons having CHD were defined as those having history of CHD and/or having abnormal Q wave and/or ischemic change in ECG. After converting CAVI scores to binary variables (normal or abnormally high CAVI scores), logistic regression analysis was conducted. Results: After adjusting for age, significant odds ratios (ORs) of abnormally high CAVI scores among men were found with diabetes mellitus (10.02, p<0.001), hypertension (8.37, p<0.001), triglycerides (2.76, p<0.001, for 150-199mg/dL and 2.85, p<0.001, for ≥200mg/dL, as reference:<150mg/dL), high density lipoprotein cholesterol (0.19, p<0.001, for 40-59mg/dL and 0.20, p<0.001 for ≥60mg/dL, as reference: <40mg/dL), body mass index (2.04, p<0.001, for <20, 2.31, p<0.001, for 28-29.9 and 3.37, p<0.001, for ≥30 as reference:20-22.9), and ex-smokers (1.20, p<0.01, as reference: non-smokers). Almost identical results were found among women, except a significant OR with current smokers (2.25, p<0.001). The significant association between CHD and abnormally high CAVI scores was found: OR=3.87, p<0.001 for men and 1.45, p<0.01 for women after adjusting for CVD risk factors. Conclusions: Our results confirmed that CAVI scores are a reliable indicator of arteriosclerosis reflecting the extent of arterial stiffness and atherosclerosis in the major artery between the aortic valve and the ankle.
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