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Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2018;71:458-65 - Vol. 71 Num.06 DOI: 10.1016/j.rec.2017.09.011

Association of Classic Cardiovascular Risk Factors and Lifestyles With the Cardio-ankle Vascular Index in a General Mediterranean Population

Marc Elosua-Bayés a, Ruth Martí-Lluch a,b,c, María del Mar García-Gil a,b, Lourdes Camós a, Marc Comas-Cufí a,b, Jordi Blanch a,b, Anna Ponjoan a,b,c, Lia Alves-Cabratosa a,b, Roberto Elosua d,e, María Grau d,e, Jaume Marrugat d,e,, Rafel Ramos a,b,c,f,

a Institut Universitari d’Investigació en Atenció Primària Jordi Gol (IDIAP Jordi Gol), Barcelona, Spain
b Grup Investigació en Salut Cardiovascular de Girona (ISV-Girona), Unitat de Recerca en Atenció Primària, Serveis en Atenció Primària, Institut Català de Salut (ICS), Girona, Spain
c Institut d’Investigació Biomèdica de Girona (IdIBGi), ICS, Girona, Spain
d Registre Gironí del Cor (REGICOR) Grupo de Investigación en Epidemiología y Genética Cardiovascular (EGEC), Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), Barcelona, Spain
e CIBER Enfermedades Cardiovasculares, Barcelona, Spain
f Departament de Ciències Mèdiques, Universitat de Girona, Girona, Spain


Arterial stiffness. Atherosclerosis. Cardio-ankle vascular index. Cardiovascular risk factors. Cardiovascular risk. Lifestyles.


Introduction and objectives

The cardio-ankle vascular index (CAVI) assesses arterial stiffness. We aimed to describe the distribution of CAVI in a Mediterranean population, to determine the proportion of CAVI ≥ 9 by sex and coronary risk level, and to assess the association of CAVI with classic cardiovascular risk factors and lifestyle patterns.


This cross-sectional study was based on the population of Girona province. The CAVI was measured using the VaSera VS-1500.


Of 2613 individuals included in this study, the prevalence of CAVI ≥ 9 was 46.8% in men and 36.0% in women and significantly increased with coronary risk: from 21.1% and 24.8%, respectively to 76.7%, in the low-risk group, and 61.9% in the high-risk group. The CAVI increased with age in both sexes, being higher in men across all age groups. In men, CAVI ≥ 9 was associated with hypertension (OR, 2.70; 95%CI, 1.90-3.87) and diabetes (OR, 2.38; 95%CI, 1.52-3.78), body mass index (BMI) ≤ 25 to < 30 (OR, 0.44; 95%CI, 0.27-0.72) and BMI ≥ 30 (OR, 0.28; 95%CI, 0.14-0.58), and physical activity (OR, 0.66; 95%CI, 0.47-0.92). In women, CAVI ≥ 9 was associated with hypertension (OR, 2.22; 95%CI, 1.59-3.09), hypercholesterolemia (OR, 1.40; 95%CI, 1.01-1.94), and BMI ≥ 30 (OR, 0.38; 95%CI, 0.20-0.71).


The CAVI increases with age and is higher in men than in women. This index is associated with classic risk factors and coronary risk. It could be a good predictive biomarker, but further follow-up studies are required to assess its added value to cardiovascular risk stratification.


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1885-5857/© 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved