Noriko Satoh-Asahara1, Kazuhiko Kotani2, Hajime Yamakage3, Tsutomu Yamada4, Rika Araki5, Taiichiro Okajima6, Masahiro Adachi6, Mariko Oishi7, Akira Shimatsu3. 1. Division of Diabetic Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan. Electronic address: nsatoh@kuhp.kyoto-u.ac.jp. 2. Division of Diabetic Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan; Division of Community and Family Medicine, Jichi Medical University, Shimotsuke, Japan. 3. Division of Diabetic Research, Clinical Research Institute, National Hospital Organization Kyoto Medical Center, Kyoto, Japan. 4. Department of Endocrinology and Diabetes, National Hospital Organization Nagoya Medical Center, Nagoya, Japan. 5. Internal Medicine, National Hospital Organization Mie Hospital, Mie, Japan. 6. Department of Internal Medicine, National Hospital Organization Kokura Medical Center, Kitakyu-syu, Japan; Department of Clinical Research, National Hospital Organization Kokura Medical Center, Kitakyu-syu, Japan. 7. Oishi Clinic, Kyoto, Japan.
Abstract
OBJECTIVE: The cardio-ankle vascular index (CAVI) is an index of arterial stiffness less dependent on blood pressure and an indicator suitable for assessing the arterial dysfunction. However, it remains unclear whether CAVI can predict the outcome of cardiovascular diseases (CVD) in obese patients. METHODS: A total of 425 obese Japanese outpatients (189 men and 236 women, mean age: 51.5 years) were enrolled in a multicenter prospective cohort Japan, the Japan Obesity and Metabolic Syndrome Study (JOMS). Primary analysis regarding measurements of cardiovascular risk factors including CAVI and the occurrence of macrovascular complications was based on following the participants over a 5-year period. RESULTS: Of the eligible patients, 300 (78%) were followed into the fifth year. During the study period, 15 coronary heart disease, 7 stroke, and 6 arteriosclerosis obliterans events occurred. All events occurred in 28 patients, and CVD incidence rate was 15.8 per 1000 person-years. In the analysis of adjusted models for traditional risk factors, CAVI was a significant factor for the incidence of events. In addition, high CAVI and low HDL-cholesterol were significant factors for the incidence of events in Cox stepwise multivariate analysis when age- and sex-adjusted (CAVI [per 1]: HR = 1.44 [1.02-2.02], p = 0.037; HDL-cholesterol [per 1 mmol/L]: HR = 0.20 [0.06-0.69], p = 0.011). In addition, CAVI added value to atherosclerotic cardiovascular disease risk score in predicting the development of CVD. CONCLUSION: This study demonstrates for the first time that CAVI is an effective predictor of CVD events in obese patients.
OBJECTIVE: The cardio-ankle vascular index (CAVI) is an index of arterial stiffness less dependent on blood pressure and an indicator suitable for assessing the arterial dysfunction. However, it remains unclear whether CAVI can predict the outcome of cardiovascular diseases (CVD) in obesepatients. METHODS: A total of 425 obese Japanese outpatients (189 men and 236 women, mean age: 51.5 years) were enrolled in a multicenter prospective cohort Japan, the Japan Obesity and Metabolic Syndrome Study (JOMS). Primary analysis regarding measurements of cardiovascular risk factors including CAVI and the occurrence of macrovascular complications was based on following the participants over a 5-year period. RESULTS: Of the eligible patients, 300 (78%) were followed into the fifth year. During the study period, 15 coronary heart disease, 7 stroke, and 6 arteriosclerosis obliterans events occurred. All events occurred in 28 patients, and CVD incidence rate was 15.8 per 1000 person-years. In the analysis of adjusted models for traditional risk factors, CAVI was a significant factor for the incidence of events. In addition, high CAVI and low HDL-cholesterol were significant factors for the incidence of events in Cox stepwise multivariate analysis when age- and sex-adjusted (CAVI [per 1]: HR = 1.44 [1.02-2.02], p = 0.037; HDL-cholesterol [per 1 mmol/L]: HR = 0.20 [0.06-0.69], p = 0.011). In addition, CAVI added value to atherosclerotic cardiovascular disease risk score in predicting the development of CVD. CONCLUSION: This study demonstrates for the first time that CAVI is an effective predictor of CVD events in obesepatients.
Authors: Kunihiro Matsushita; Ning Ding; Esther D Kim; Matthew Budoff; Julio A Chirinos; Bo Fernhall; Naomi M Hamburg; Kazuomi Kario; Toru Miyoshi; Hirofumi Tanaka; Raymond Townsend Journal: J Clin Hypertens (Greenwich) Date: 2018-11-19 Impact factor: 3.738
Authors: Matthew J Budoff; Bruce Alpert; Julio A Chirinos; Bo Fernhall; Naomi Hamburg; Kazuomi Kario; Iftikhar Kullo; Kunihiro Matsushita; Toru Miyoshi; Hirofumi Tanaka; Ray Townsend; Paul Valensi Journal: Am J Hypertens Date: 2022-05-10 Impact factor: 3.080