CAVI (cardio-ankle vascular index) as an independent predictor of hypertensive response to exercise

Abstract

Abstract Objectives Hypertensive response to exercise (HRE) always acts as a relative indication to terminate exercise during treadmill stress test and prohibit the interpretation of inadequate result. We supposed the CAVI (Cardio-ankle vascular index) might be an initial clue to predict hypertensive response to exercise. Material and methods Retrospective chart review in cardiology unit, patients who attended health preventive program in our heart hospital, and performed both CAVI and treadmill stress test in the same day between June 2018 and December 2018. Variables for prediction of HRE were analyzed, using univariate analysis and significant variables were entered in multiple logistic regression. ROC curve was created to test the sensitivity and specificity when used CAVI >8 as a cut-point of increased arterial stiffness. Results 285 patients (157 females, 55.1%) were enrolled in this study. 58 patients (20.4%) who matched with HRE definition (SBP ≥210 mmHg or DBP ≥100 mmHg in male, SBP ≥190 mmHg or DBP ≥95 mmHg in female), mean age 46.4±12.8 years. In univariate analysis; age, diabetes mellitus, hypertension, dyslipidemia, history taking beta-blocker, and CAVI result were statistically significant. Multiple logistic regression revealed only CAVI result was statistically significant predictor of HRE (OR 5.8, 95% CI: 3.5–10.9, P<0.001). ROC curve analysis of the CAVI revealed AUC 0.827 (95% CI: 0.76–0.89, p<0.001) and the sensitivity and specificity of cut-point CAVI ≥8 were 53% and 92% respectively. Conclusion This study demonstrated CAVI is an independent predictor for hypertensive response to exercise. CAVI ≥8 is not the sensitive tool but quite specific to detect HRE. Funding Acknowledgement Type of funding sources: Private hospital(s). Main funding source(s): Bangkok Dusit Medical services