Increased brachial-ankle pulse wave velocity is independently associated with white matter hyperintensities

Neuroepidemiology. 2011;36(4):252-7. doi: 10.1159/000328260. Epub 2011 Jun 16.

Abstract

Background: White matter hyperintensities (WMHs) are a risk factor for stroke. Their etiology is considered to be cerebral microvascular abnormality. However, the association between WMHs and arteriosclerosis is not yet clear. The aim of this hospital-based cohort study was to identify the arteriosclerotic characteristics associated with WMHs.

Methods: We cross-sectionally included 240 consecutive patients with no history of stroke. We measured the brachial-ankle pulse wave velocity (baPWV), ankle brachial pressure index, and intima-media thickness of the common carotid artery, and we performed magnetic resonance brain imaging. WMHs were defined as periventricular hyperintensity (Fazekas grade ≥3) and/or separate deep white matter hyperintense signals (Fazekas grade ≥2). We determined the prevalence of WMHs, silent brain infarction (SBI), hypertension, hypercholesterolemia, diabetes mellitus, ischemic heart disease, and smoking. We compared 2 groups of patients, defined by the presence or absence of WMHs, using multiple logistic regression analyses.

Results: In multivariable analysis, SBI (OR 3.38; 95% CI 1.52-7.72), hypertension (OR 2.23; 95% CI 1.03-5.15), female sex (OR 1.95; 95% CI 1.03-3.76), baPWV (OR 1.12; 95% CI 1.02-1.23), and age (OR 1.09; 95% CI 1.04-1.14) were independently associated with WMHs.

Conclusions: An increased baPWV is associated with WMHs. Management of increased baPWV may help to prevent the progression of WMHs and stroke.

MeSH terms

  • Aged
  • Ankle Brachial Index / methods*
  • Ankle Brachial Index / statistics & numerical data
  • Blood Flow Velocity
  • Brain / pathology*
  • Carotid Artery, Common / diagnostic imaging
  • Cohort Studies
  • Cross-Sectional Studies
  • Female
  • Humans
  • Imaging, Three-Dimensional / methods
  • Magnetic Resonance Imaging / methods
  • Male
  • Middle Aged
  • Nerve Fibers, Myelinated / pathology*
  • Odds Ratio
  • Risk Factors
  • Tunica Intima / diagnostic imaging
  • Tunica Media / diagnostic imaging
  • Ultrasonography