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Cardio-ankle vascular index and plasma lipids in patients with hypertension: causality of the association

Journal of Human Hypertension volume 29, page 137 (2015)Cite this article

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I have read with interest a cross-sectional study by Wang et al.1 reporting the positive association between cardio-ankle vascular index (CAVI), an index of arterial stiffness, and plasma lipids in patients with hypertension. The authors concluded that arterial stiffness was closely associated with lipid metabolism in hypertension. I have some concerns on their study.

Pulse wave velocity (PWV) has been measured to estimate the level of atherosclerosis,2 and the cardio-ankle vascular index (CAVI) was developed by improving PWV method for the assessment of arterial stiffness.3,4 Theoretically, CAVI can measure arterial stiffness independent of blood pressure,5 but there is a report of positive association between CAVI and blood pressure.6 Originally, CAVI was used to obtain a pressure-independent index. But normalization for blood pressure in the computation of CAVI is imperfect, and there is still a pressure dependency of CAVI. As the adjustment procedure of blood pressure for CAVI has not been open, wide use of CAVI seems to be limited in clinical field. I speculate that the effect of blood pressure on CAVI would become relatively small when only hypertensive subjects were selected for the analysis. Wang et al. also used CAVI by adjusting age, gender and blood pressure. My first concern is the advantage of using CAVI instead of PWV in their study, because PWV has been widely distributed for the evaluation of arterial stiffness.

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References

  1. Wang H, Liu J, Zhao H, Zhao X, Li L, Shi H et al. Relationship between cardio-ankle vascular index and plasma lipids in hypertension subjects. J Hum Hypertens (e-pub ahead of print 15 May 2014; doi:10.1038/jhh.2014.37).

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  7. Soska V, Frantisova M, Dobsak P, Dusek L, Jarkovsky J, Novakova M et al. Cardio-ankle vascular index in subjects with dyslipidaemia and other cardiovascular risk factors. Atheroscler Thromb 2013; 20: 443–451.

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  1. Department of Hygiene and Public Health, Nippon Medical School, Tokyo, Japan

    T Kawada

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  1. T Kawada
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Correspondence to T Kawada.

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Kawada, T. Cardio-ankle vascular index and plasma lipids in patients with hypertension: causality of the association. J Hum Hypertens 29, 137 (2015). https://doi.org/10.1038/jhh.2014.67

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