Small Vessel Disease

Abstract

Small vessel disease (SVD) refers to conditions where damage to arterioles and capillaries is predominant, leading to reduced, or interrupted perfusion of the affected organ. Data suggest that when this condition is evident in any organ, it is already systemic in its occurrence and consequences. SVD affects primarily organs that receive significant portions of cardiac output such as the brain, the kidney, and the retina. Thus, SVD is a major etiologic cause in debilitating conditions such as renal failure, blindness, lacunar infarcts, and dementia. The factors that lead to this devastating condition include all the known vascular risk factors when they are not strictly controlled, but lifestyles that include sedentary existence, obesity, and poor sleep patterns are also recognized drivers of SVD. In addition, depression is now recognized as a vascular risk factor. Inflammation is a mediator of SVD, but it is not known which factor(s) predominate in its etiology. This article emphasizes the need for more investigations to define this link further and suggests clinical and societal responses that might reduce the major impacts of this condition on populations.

Vasculo-Neuronal Coupling and Neurovascular Coupling at the Neurovascular Unit: Impact of Hypertension

“…Reduced CBF is correlated with accelerated cognitive decline and ultimately leads to dementia (Hakim, 2019). Using MRI analyses and clinical history data for 59 patients who suffered a transient ischemic attack, Wang and colleagues reported that 67.8% of such patients presented a history of hypertension.…”

Structural and Functional Remodeling of the Brain Vasculature Following Stroke

“…While exciting new developments are in the pipeline, several lines of investigation indicate a significant impact lifestyle has on vascular health ( Hakim, 2014 , 2019 ) and particularly on brain angiogenesis and stroke outcome ( Schmidt et al, 2013 ). A short interval of exercise prior to stroke was shown to improve functional outcomes by enhancing angiogenesis ( Pianta et al, 2019 ).…”

Diets and Cellular-Derived Microparticles: Weighing a Plausible Link With Cerebral Small Vessel Disease

“…The condition may lead to alteration of microcirculation (i.e., blood flow or perfusion) of the affected organ. SVD is generally observed in major organs such as the brain, retinal, heart, and urinary system (i.e., kidney), due to fact that these organs primarily required a desirable amount of cardiac output for their functionality (27). However, the GIT arteries are rarely affected to vascular disease either SVD or large vessel disease (i.e., atherosclerosis) (28).…”

“…Interestingly, recent evidence suggested that higher SVD incidence is associated with an increased systemic inflammation due to poor sleep quality (39), as well as societal-based depression and loneliness (40)(41)(42). Besides, individual(s) with SVD is suggested to suffer from "systemic" condition (27). This is so as SVD is commonly associated with nervous system disturbances such as stroke, cognitive decline, vascular dementia, and gait dysfunction (43)(44)(45)(46).…”