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Risk Factors.

T Uehara, O Y Bang, J S Kim

Frontiers of Neurology and Neuroscience

|December 14, 2016

Summary

Risk factors for intracranial atherosclerosis (ICAS) differ from extracranial atherosclerosis (ECAS). Intracranial arteries are more vulnerable to diabetes and hypertension, explaining racial disparities in atherosclerosis location.

Area of Science:

Neurology
Vascular Medicine
Epidemiology

Background:

Studies on intracranial atherosclerosis (ICAS) risk factors are increasing due to advanced imaging.
Conventional risk factors like hypertension, diabetes, hypercholesterolemia, and smoking are implicated in ICAS.
Differences in risk factors between ICAS and extracranial atherosclerosis (ECAS), and racial disparities in ICAS prevalence, require further investigation.

Purpose of the Study:

To review and analyze existing evidence on risk factors for ICAS.
To explore potential differences in risk factors between ICAS and ECAS.
To understand the reasons behind the higher prevalence of ICAS in certain racial groups.

Main Methods:

Review of heterogeneous studies on ICAS risk factors.

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Analysis of available evidence on differences between ICAS and ECAS.

Consideration of factors influencing racial disparities in atherosclerosis location.

Main Results:

Hypercholesterolemia appears more strongly associated with ECAS than ICAS.
Intracranial arteries may be more susceptible to antioxidant depletion (diabetes, metabolic syndrome) and hemodynamic stress (hypertension, arterial tortuosity).
Genetic factors (e.g., RNF 213) and non-atherosclerotic diseases (e.g., moyamoya) may contribute to racial differences.

Conclusions:

Risk factor profiles for ICAS and ECAS likely differ.
Vulnerability of intracranial arteries to specific risk factors and genetic predispositions contribute to racial variations.
Further prospective, well-designed studies in diverse ethnic groups are crucial for understanding ICAS pathogenesis and prevention.