Associations of Arterial Stiffness and Carotid Atherosclerosis with Cerebral Small Vessel Disease in a Rural Community-Based Population

Abstract

Aims : We aimed to examine the associations of four extracranial artery indicators with cerebral small vessel disease (CSVD) and its total burden. Methods: A total of 904 individuals aged 55–65 years old were included from the Taizhou Imaging Study. CSVD markers, including lacunes (LAC), white matter hyperintensities (WMH), cerebral microbleeds (CMB), and perivascular spaces (PVS), were rated based on brain magnetic resonance imaging. We also measured extracranial artery indices, including the brachial-ankle pulse wave velocity (baPWV), the ankle-brachial index, the carotid intima-media thickness (IMT), and carotid plaque. Linear and binary logistic regressions were adopted to test the associations among these four artery indicators and each CSVD marker when appropriate. Additionally, ordinal and multinomial logistic regressions were performed to assess the relationships between artery indicators and total CSVD score (range from 0–4 points). Results: A total of 443 (49.0%) participants were found to have at least one of the CSVD markers, including 172 (19.0%) with WMH, 184 (20.4%) with LAC, 147 (16.3%) with CMB, and 226 (25.0%) with PVS. Increased baPWV was significantly associated with each CSVD marker, increasing carotid IMT was associated with LAC and PVS, and the presence of carotid plaque was associated with WMH volume and PVS. Moreover, per SD increment of baPWV (odds ratio [OR]: 1.29, 95% confidence interval [CI]: 1.11–1.50) and the presence of carotid plaque (OR: 1.42, 95% CI: 1.05–1.92) were significantly associated with greater total CSVD scores. Conclusion : Increased baPWV and the presence of carotid plaque appear to be associated with total CSVD burden in rural regions in China.

Brachial‐ankle pulse wave velocity as a measurement for increased carotid intima‐media thickness: A comparison with carotid‐femoral pulse wave velocity in a Chinese community‐based cohort

“…Third, a recent study found that increased baPWV, not increased cIMT, was significantly associated with total cerebral small vessel disease burden in a Chinese rural community‐based population. 43 Therefore, even if cfPWV was more strongly associated with increased cIMT than baPWV in our study, we cannot infer that cfPWV is better associated with overall cardiovascular disease or other hypertensive target organ damage.…”

Lifestyle, multi‐omics features, and preclinical dementia among Chinese: The Taizhou Imaging Study

“…A flowchart of the participant selection procedure is shown in Figure 2. Detailed TIS study population recruitment and procedures have been reported elsewhere 15,16,24,25,27 …”

“…Another two indicators of arterial stiffness, ie, brachial–ankle pulse wave velocity (baPWV) and ankle–brachial index (ABI) were measured by an automatic waveform analyzer. All the measurements were performed by the same experienced technician on the same machine 27 …”

“…Individuals in three villages been reported elsewhere. 15,16,24,25,27 Fluency Test. Considering reading and writing skills are required in certain tests, we separated the neuropsychological battery into two versions according to the education level of participants.…”

Brachial–Ankle Pulse Wave Velocity: A Most Predictable Arterial Measure for Cerebral Small Vessel Disease

“…In this issue of the Journal of Atherosclerosis and Thrombosis, Kexun Zhang et al examined the relationship between four extracranial arterial measures [i.e., brachial-ankle pulse wave velocity (baPWV), ankle-brachial index, carotid intima-media thickness (IMT), and carotid plaque] and four CSVD markers (i.e., LAC, WMH, CMB, and PVS) and their total burden in 904 participants in the general population recruited from the Taizhou Imaging Study 5) . A total of 443 (49.0%) participants were identified to have at least one of the CSVD markers: 172 (19.0%) with WMH, 184 (20.4%) with LAC, 147 (16.3%) with CMB, and 226 (25.0%) with PVS.…”