Higher arterial stiffness, measured by aortic pulse wave velocity, was associated with larger white matter lesion volume (difference per SD increase 0.07; 95% CI, 0.02-0.12).
Observational (n=1,460)
Is increased arterial stiffness associated with cerebral small vessel disease?
Increased arterial stiffness is associated with a larger volume of white matter lesions, particularly in individuals with uncontrolled hypertension.
Effect estimate: Difference 0.07 (95% CI 0.02-0.12)
BACKGROUND AND PURPOSE: Aging and vascular risk factors contribute to arterial stiffening. Increased arterial stiffness exposes the small vessels in the brain to abnormal flow pulsations and, as such, may contribute to the pathogenesis of cerebral small vessel disease. In a population-based study, we investigated the association between arterial stiffness, as measured by aortic pulse wave velocity (aPWV), and small vessel disease. METHODS: Overall, 1460 participants (mean age, 58.2 years) underwent aPWV measurement and brain MRI scanning. We calculated aPWV by measuring time differences and distances between pulse waves in the carotid and femoral arteries. Using automated MRI analysis, we obtained white matter lesion volumes. Infarcts and microbleeds were rated visually. We used linear and logistic regression models to associate aPWV with small vessel disease, adjusting for age, sex, mean arterial pressure, and heart rate and additionally for cardiovascular risk factors. Subsequently, we explored associations in strata of hypertension. RESULTS: In the study group, higher aPWV was associated with larger white matter lesion volume (difference in volume per SD increase in aPWV 0.07; 95% CI, 0.02-0.12) but not with lacunar infarcts or microbleeds. In persons with uncontrolled hypertension, higher aPWV was significantly associated with larger white matter lesion volume (difference in volume per SD increase in aPWV 0.09; 95% CI, 0.00-0.18), deep or infratentorial microbleeds (OR, 2.13; 95% CI, 1.16-3.91), and to a lesser extent also with lacunar infarcts (OR, 1.63; 95% CI, 0.98-2.70). No such associations were present in persons with controlled hypertension or without hypertension. CONCLUSIONS: In our study, increased arterial stiffness is associated with a larger volume of white matter lesions.
Poels et al. (2012) conducted an observational in Cerebral small vessel disease (n=1,460). Aortic pulse wave velocity (aPWV) was evaluated on White matter lesion volume (Difference 0.07, 95% CI 0.02-0.12). Higher arterial stiffness, measured by aortic pulse wave velocity, was associated with larger white matter lesion volume (difference per SD increase 0.07; 95% CI, 0.02-0.12).