Arterial Stiffness Using Cardio-Ankle Vascular Index Reflects Cerebral Small Vessel Disease in Healthy Young and Middle Aged Subjects

Aim: The cardio-ankle vascular index (CAVI) reflects overall arterial stiffness from the aorta to the ankle, independent of blood pressure. Cerebral small vessel diseases (SVDs), including white matter lesions (WML), silent lacunar infarction (SLI) and cerebral microbleeds (CMB), are considered to increase the risk of stroke and cognitive impairment further. We aimed to investigate the association of cerebral SVD with CAVI in asymptomatic young and middle-aged subjects. Methods: Asymptomatic Korean individuals aged 30 to 59 years old without neurologic disease who had CAVI and brain magnetic resonance imaging (MRI) were evaluated retrospectively. Results: Among 484 subjects, cerebral SVDs (advanced WML, SLI and CMB) were found in 20 (4.1%). Subjects with SVDs tended to be older and to have higher systolic blood pressure (SBP) and higher CAVI. From multivariate regression analysis, including pulse pressure (PP) or SBP, CAVI showed a significant association with SVD [adjusted OR (95% CI): 1.889 (1.094-3.263), p=0.002 and 1.793 (1.020-3.153), p=0.043, for PP and SBP, respectively]. When CAVI was assessed by quartiles, the highest quartile of CAVI (CAVI>7.65) showed a significant association with SVD, after adjustment for PP [adjusted OR (95% CI): 2.766 (1.115-6.866), p=0.028]. Conclusion: In young and middle-aged subjects, cerebral SVD was significantly associated with arterial stiffness measured by CAVI after adjusting for PP or SBP.