Silent cerebrovascular disease in hypertensive adults is frequent and age-dependent

Abstract

Background: Cerebral small vessel disease and extracranial atherosclerotic carotid disease are manifestations of silent cerebrovascular disease (CVD). Information on these two pathologies in hypertensive population with low cardiovascular risk (CVR) is scarce. Objective: To explore frequency and characteristics of silent CVD in hypertensive adults and cognitive repercussion of these alterations. Methods: 39 hypertensive patients (mean age: 53.5 years) were studied. Cerebral magnetic resonance imaging (3T), doppler ultrasound of the carotid artery and neuropsychological studies were obtained. Results: 79% of patients presented white matter lesions (WML), 18% showed only cerebral atrophy and/or enlarged perivascular spaces, 60% presented hyperplasia of intimal media complex (IMC) and/or atheroma plaques. In women, a signifi cant correlation was observed between IMC thickness and bifrontal index, and WML was greater in patients with carotid plaques. A non-signifi cant decrease in neuropsychological performance was observed in the groups of patients with intra and/or extracerebral injury and a negative correlation with the bifrontal index in men was found. Conclusion: Frequency of intra and extracerebral silent CVD was high in hypertensive adults with low to moderate CVR. WML and brain atrophy were partially related with carotid lesions. Age signifi cantly infl uenced the appearance of intra and extracerebral lesions. Cognitive performance did not decrease signifi cantly due to the presence of these lesions.c Silent cerebrovascular disease in hypertensive adults is frequent and age-dependent

Asymptomatic cerebral small vessel disease in adults with low cardiovascular risk

“…Previous studies in Cuba had revealed that the proportion of subjects with low CV risk fluctuated between 59% and 86% in asymptomatic adults 23 24. With the revised WHO CV disease risk prediction charts, this proportion will undoubtedly change, considering that the cut-off for low CV risk has been set to <5%, instead of <10% as previously established 15.…”

“…A small investigation was recently conducted by us in 39 hypertensive patients, where CV risk was assessed with the PAHO CV risk calculator. 23 Although the MRI variables were not evaluated in the same manner, a high frequency of MRI lesions was encountered in patients with low to moderate CV risk, suggesting a limited association of brain parenchymal involvement with the level of CV risk.…”