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Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions
07:30

Evaluation of the Cognitive Performance of Hypertensive Patients with Silent Cerebrovascular Lesions

Published on: April 23, 2021

Different patterns of silent cerebral infarct in patients with coronary artery disease or hypertension

S Hoshide1, K Kario, T Mitsuhashi

  • 1Department of Cardiology, Jichi Medical School, Tochigi, Japan.

American Journal of Hypertension
|June 20, 2001
PubMed

Insights

Silent cerebral infarcts (SCI) are more prevalent in patients with coronary artery disease (CAD) and hypertension. Coronary atherosclerosis specifically impacts deep brain infarcts, while hypertension is linked to white matter infarcts.

Area of Science:

  • Neurology
  • Cardiology
  • Radiology

Background:

  • Silent cerebral infarcts (SCI) are crucial indicators for stroke risk.
  • SCI are common in patients with coronary artery disease (CAD) and hypertension.
  • Differences in SCI characteristics and risk factors between CAD and hypertensive patients require further investigation.

Purpose of the Study:

  • To compare the progression and characteristics of silent cerebral infarcts (SCI) in patients with coronary artery disease (CAD) versus hypertensive patients.
  • To identify distinct risk factors associated with SCI in these two patient groups.

Main Methods:

  • Brain magnetic resonance imaging (T1- and T2-weighted) was used to evaluate SCI.
  • 107 patients with CAD (confirmed by coronary angiography) and 101 hypertensive patients without prior stroke were analyzed.
  • Statistical analysis, including multiple logistic regression, was employed to determine independent predictors of SCI.

Main Results:

  • Multiple SCI were significantly more prevalent in patients with CAD and hypertension compared to hypertensives without CAD (46% vs. 21%).
  • In CAD patients, the number of affected coronary arteries independently predicted SCI, particularly in the deep perforator territory.
  • In hypertensive patients, age was the independent predictor for SCI, specifically in the white matter.

Conclusions:

  • Silent cerebral infarcts are more advanced in patients with multivessel CAD than in hypertensive patients.
  • Coronary atherosclerosis is specifically associated with SCI in the deep perforator territory, whereas hypertension is linked to white matter SCI.
  • Both CAD-atherosclerosis and hypertension independently contribute to the pathological process of SCI.

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