Patients with CV risk factors may develop HF through progressive arterial stiffening. A post-hoc analysis of the CAVI-J study, presented at the European Society of Cardiology Congress 2025 (ESC 2025), demonstrated that the CAVI, a blood pressure–independent marker of arterial stiffness, predicts hospitalization for HF in high-risk individuals.

The analysis included 2,932 patients aged 40–74 years who had at least one CV risk factor, including type 2 diabetes mellitus, hypertension, metabolic syndrome, chronic kidney disease, or prior coronary or cerebrovascular disease. During a median follow-up of 4.9 years, 32 patients experienced a composite endpoint of CV death or HF hospitalization.

Cumulative incidence of these outcomes was significantly higher in the highest CAVI tertile compared with the lowest (p < 0.01). A CAVI threshold of 8.9 provided optimal discrimination, with CAVI > 8.9 associated with a 3.68-fold higher risk of the primary outcome (95% CI, 1.74–7.79) after adjustment for age and sex. Subgroup analyses showed consistent results across all demographic and clinical subgroups. 

Routine CAVI assessment may help stratify HF risk and support early preventive interventions in patients with multiple CV risk factors.