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Asymptomatic cerebral small vessel disease in adults with low cardiovascular risk

Zenaida Milagros Hernández-Díaz1, Marisol Peña-Sánchez2, Mayelin Pimienta-Medina3

  • 1Neuroimaging, International Centre for Neurological Restoration, La Habana, Cuba.

BMJ Neurology Open
|February 23, 2023
PubMed

Insights

Cardiovascular risk assessment using the HEARTS app may underestimate cerebral small vessel disease (CSVD) burden, particularly in low-risk individuals. Arterial hypertension and age are key factors associated with CSVD severity.

Area of Science:

  • Neurology
  • Cardiology
  • Radiology

Background:

  • Cerebral small vessel disease (CSVD) is common in individuals with vascular risk factors but often goes unrecognized.
  • Silent CSVD can have significant implications for brain health.

Purpose of the Study:

  • To assess the relationship between cardiovascular (CV) risk, calculated using the HEARTS app, and CSVD burden in individuals without prior cardio-cerebrovascular diseases.
  • To determine the prevalence of CSVD in low CV risk populations.

Main Methods:

  • 170 asymptomatic subjects with vascular risk factors were enrolled.
  • Cardiovascular risk was assessed using the HEARTS app, categorizing individuals into low risk (LR) and moderate/high risk (M/HR) groups.
  • Brain MRI was performed to evaluate CSVD burden, including white matter hyperintensities (WMH) and enlarged perivascular spaces.

Main Results:

  • Over half of the participants (51.2%) showed signs of CSVD, irrespective of their CV risk category.
  • While CSVD burden was higher in the M/HR group (57.5%), a significant proportion of LR individuals (32.6%) also exhibited more severe CSVD.
  • Arterial hypertension and age were independently associated with increased CSVD severity.

Conclusions:

  • The HEARTS app has limited utility in predicting brain health, especially for low CV risk individuals.
  • Silent CSVD is prevalent even in those with seemingly low CV risk, highlighting the importance of considering factors like arterial hypertension.
Abstract

Keywords:
CARDIOLOGYCEREBROVASCULAR DISEASEMRI

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