Association of cardio-ankle vascular index with brain natriuretic peptide levels in hypertension

Abstract

Aims: Plasma brain natriuteric peptide (BNP) is an established marker of cardiovascular events in individuals without heart failure. Although the cardio-ankle vascular index (CAVI) is clinically used as a parameter of arterial stiffness, its usefulness for predicting cardiovascular events has not been fully examined. This study aimed to evaluate the association among CAVIs, plasma BNP levels and left ventricular (LV) hypertrophy and dysfunction in hypertensive patients. Methods: We enrolled 136 hypertensive patients (69±10 years) who had been taking antihypertensive medications for at least one year. Echocardiography was performed to evaluate LV hypertrophy and function. Plasma BNP levels and CAVIs were also measured simultaneously. Results: CAVI was correlated with plasma BNP (r = 0.245, p = 0.004). Multiple linear regression analysis revealed three independent determinants of CAVI: age (β= 0.568, p<0.001), diameter of ascending aorta (β= 0.289, p<0.001), and diabetes (β= 0.207, p = 0.003). In addition, multiple linear regression analysis revealed two independent determinants of the plasma BNP level: left atrial diameter (β= 0.334, p<0.001) and CAVI (β= 0.256, p = 0.002). Conclusion: The present study indicates that increased CAVI is independently associated with elevated plasma BNP produced by increased LV afterload, that is, arterial stiffness, in hypertensive patients. Moreover, the present study raises the possibility that CAVI may be as useful as the plasma BNP level for predicting the risk of cardiovascular events in hypertensive patients.