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Cerebral Small Vessel Disease Associated with Subclinical Vascular Damage Indicators in Asymptomatic Hypertensive

Zenaida Milagros Hernández-Díaz1, Marisol Peña-Sánchez2, Alina González-Quevedo Monteagudo2

  • 1Department of Neuroimagenology, International Center for Neurological Restoration, 25th Ave, Playa, 15805, Havana 11300, Cuba. zmhernandez@neuro.ciren.cu.

Behavioral Sciences (Basel, Switzerland)
|August 25, 2019
PubMed

Insights

Early detection of cerebral small vessel disease (CSVD) in asymptomatic hypertensive patients is possible by combining vascular damage indicators. This approach aids in preventing stroke and cognitive decline.

Area of Science:

  • Neurology
  • Cardiology
  • Radiology

Background:

  • Cerebral small vessel disease (CSVD) is common in hypertensive patients.
  • CSVD is linked to broader vascular damage and increased risk of stroke, cognitive impairment, and dementia.
  • Early CSVD diagnosis is crucial for preventing severe outcomes.

Purpose of the Study:

  • To characterize CSVD in asymptomatic hypertensive individuals.
  • To identify associations between CSVD and subclinical vascular damage indicators.

Main Methods:

  • Compared hypertensive (HT) and non-hypertensive (non-HT) individuals without cerebrovascular disease, dementia, or renal failure.
  • Assessed CSVD via MRI (white matter hyperintensities, enlarged perivascular spaces, lacunar infarcts, microbleeds).
  • Evaluated subclinical vascular damage including retinopathy, microalbuminuria, and carotid morphology (IMT, plaque).

Main Results:

  • CSVD MRI findings and intimal thickening were more prevalent in hypertensive patients.
  • Carotid intima-media thickness (IMT) plus plaque significantly correlated with all MRI CSVD indicators.
  • Microalbuminuria was linked to greater white matter hyperintensity severity in hypertensive patients.

Conclusions:

  • CSVD in hypertensive patients is independently associated with combined vascular damage indicators and systolic blood pressure.
  • Integrating carotid morphology, microalbuminuria, and retinopathy aids early CSVD detection in asymptomatic hypertensives.
  • Early detection facilitates interventions to prevent irreversible brain damage, cognitive decline, dementia, and stroke.

Keywords:
brain lesionscerebral small vessel diseaseessential hypertensionrisk factorswhite matter hyperintensities

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