Background: Pulse wave velocity (PWV) is an index of arterial stiffness in the descending aorta, whereas cardio-ankle vascular index (CAVI) can reveal ascending aorta and aortic arch stiffness. The number and region of aortic calcifications may affect PWV and CAVI differently.

Methods: We included 221 men and 128 women in this study. Calcifications in the ascending aorta (region A), aortic arch (region B), descending aorta (region C), and abdominal aorta (region D) were visually confirmed using computed tomography, and participants were classified into five groups based on the number of aortic calcifications using the calcium (Ca) score. Correlations of the Ca score with CAVI and arteriosclerosis risk factors were investigated. Further, these factors were compared among the five groups and in the different aortic calcification regions.

Results: CAVI, age, height, systolic blood pressure, pulse pressure (PP), smoking score, and the number of risk factors were significantly correlated with the Ca score in both men and women. We observed significant differences in CAVI, height, hypertension, dyslipidemia, and diabetes among the five groups. In men, higher smoking scores were significantly associated with calcifications in region D than in region B, and higher CAVIs were significantly associated with calcifications in regions C and D than in regions B and D. In women, height and PP were significantly different between regions B and D.

Conclusions: CAVI was correlated with the number and region of aortic calcifications. Many arteriosclerosis risk factors promoted aortic calcification; moreover, height, smoking score, and PP were related to the region of calcification. These findings may facilitate the diagnosis and treatment of arterial stiffness.