Assessment of arterial stiffness in an older population: the interest of the cardio-ankle vascular index (CAVI)

The clinical complications of arterial aging, mainly heart failure and stroke, but also coronary and other arterial atherosclerotic disease, renal failure and dementia, are all major causes of loss of autonomy, morbidity, and mortality in older subjects. Arterial stiffness is a key arterial alteration during the aging process leading to cardiovascular morbidity and mortality. Assessment of arterial stiffness can identify the subjects who are at higher risk of developing cardiovascular complications and other age-related diseases. Several methods have been developed over the past few years in order to non-invasively measure arterial stiffness. The most common approach is the measurement of pulse wave velocity, which has shown promise over the last few years in detecting subjects at high risk of CV complications. However, PWV values depend on both the intrinsic elastic properties of the arterial wall and on distension pressure (blood pressure) levels. In this paper, we develop the topic of using methods that are much less dependent on BP levels, which especially in the very old, depend mainly on co-morbidities and frailty. In this respect, the use of the cardio-ankle vascular index (CAVI) in the assessment of age-related arterial stiffening is of major interest, since the dependency of CAVI on BP levels is much weaker. Therefore, CAVI can better assess the effects of ageing on intrinsic elastic properties.