Metabolic risks, white matter hyperintensities, and arterial stiffness in high-functioning healthy adults
Journal
International Journal of Cardiology
Journal Volume
143
Journal Issue
2
Pages
184-191
Date Issued
2010
Author(s)
Kuo H.-K.
Chen C.-Y.
Chang C.-C.
Yu Y.-H.
Abstract
Background: Arterial stiffness, an age-related feature and measured noninvasively by pulse wave velocity (PWV), is associated with a variety of cardiovascular diseases. Although white matter lesion (WML), representing cerebrovascular micro-angiopathy, is typically considered as a preclinical cardiovascular disease, little is know about the association between PWV and WML. The aim of this study is to examine the association between PWV and WML. Method: We examined the extent of white matter lesion on cranial magnetic resonance imaging of 93 participants (mean 72.46 years) from the annual Health Examination for the Elderly Program in the National Taiwan University Hospital. Two subtypes of WML including periventricular hyperintensity (PVH) and deep white matter hyperintensity (DWMH) were graded according to Fazekas et al. The brachial-ankle PWV (baPWV) and heart-ankle PWV (haPWV) were measured using an automatic waveform analyzer. Results: PVH and DWHM were found in 71 (76%) and 58 (62%) participants. Various degree of WML was observed in 80 (86%) participants. Hypertension, use of anti-hypertensive medications, and elevated blood pressure were identified as risk factors of WML. The baPWV and haPWV were correlated with many metabolic risks, including systolic blood pressure, pulse pressure, and serum triglycerides. The baPWV and haPWV were greater in participants with higher grades of WML in the multivariate analyses. The receiver operating characteristics analyses demonstrated that area under curves for haPWV to identify moderate-to-severe PVH and DWMH were 0.78 (95% confidence interval [CI] 0.66-0.91) and 0.72 (95% CI 0.59-0.85), respectively. Conclusion: Greater PWV is associated with higher grades of WML among high-functioning older adults. Our findings support the notion that measurement of arterial stiffness is useful in clinical practice for detection of preclinical cerebrovascular disease. ? 2009 Elsevier Ireland Ltd.
SDGs
Other Subjects
antihypertensive agent; aged; ankle; antihypertensive therapy; area under the curve; arterial stiffness; article; autoanalyzer; brachial ankle pulse wave velocity; brachial artery; cerebrovascular disease; confidence interval; controlled study; deep white matter hyperintensity; disease association; disease classification; disease severity; female; heart; heart ankle pulse wave velocity; human; hypertension; major clinical study; male; metabolic disorder; microangiopathy; multivariate analysis; nuclear magnetic resonance imaging; periventricular hyperintensity; priority journal; pulse wave; receiver operating characteristic; risk assessment; white matter lesion; Aged; Ankle Brachial Index; Blood Pressure; Cerebral Arteries; Cerebrovascular Circulation; Cerebrovascular Disorders; Female; Humans; Hyperlipidemias; Hypertension; Leukoencephalopathies; Magnetic Resonance Imaging; Male; Microcirculation; Pulsatile Flow; Risk Factors; Sensitivity and Specificity; Taiwan; Waist Circumference
Type
journal article