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Association between cardiovascular disease risk factors and white matter lesions: The Tohoku Medical Megabank Cohort
Megumi Satake1, Ippei Chiba1,2, Mana Kogure1,2
1Graduate School of Medicine, Tohoku University.
Insights
Managing cardiovascular disease risk factors early is crucial, as they significantly increase white matter lesion (WML) progression, especially in younger adults. This study highlights the importance of early intervention for brain health.
Area of Science:
- Neurology
- Cardiovascular Medicine
- Radiology
Background:
- White matter lesions (WML) are linked to dementia and influenced by cardiovascular disease (CVD) risk factors.
- Longitudinal data on CVD risk factors and WML volume changes are limited, particularly in younger populations.
Purpose of the Study:
- To investigate the longitudinal association between CVD risk factors and WML volume changes.
- To examine these associations across a wide age range, including younger individuals.
Main Methods:
- A longitudinal study of 4,595 participants (ages 21-90) using brain MRI.
- Analyzed WML volume changes (per 4 years) in relation to hypertension, diabetes, dyslipidemia, and smoking.
- Stratified analyses by age groups: <50, 50-59, 60-69, and ≥70 years.
Main Results:
- Hypertension associated with increased WML in those <50 and 50-59 years.
- Diabetes and dyslipidemia linked to increased WML in those <50 years.
- Current smoking associated with increased WML in those 50-59 and ≥60 years.
Conclusions:
- WML volume changes were more pronounced in younger age groups for most CVD risk factors.
- Early management of CVD risk factors may be key to preventing WML progression and preserving brain health.
Aim:
White matter lesions (WML) are associated with dementia and they are influenced by cardiovascular disease (CVD) risk factors. Managing these risk factors may prevent WML progression. However, few longitudinal studies have examined the association between CVD risk factors and changes in the WML volume. This study aimed to investigate this association across a broad age range, including younger individuals.
Methods:
This longitudinal study included 4,595 participants (age range, 21-90 years; women, 61.7%) who underwent brain magnetic resonance imaging. WML was defined on T1-weighted images. The associations between each CVD risk factor (hypertension, diabetes, dyslipidemia, and current smoking) and WML volume changes (per 4 years) were analyzed using a generalized linear model with estimated regression coefficients (β) and 95% confidence intervals (CI). The analyses were stratified by age group (＜50, 50-59, 60-69, and ≥ 70 years).
Results:
Hypertension was significantly associated with increased WML volume change in those aged ＜50 and 50-59 years (β [95%CI] = 57.1 [8.0-106.2] and β [95%CI] = 77.9 [6.8-149.0], respectively). For both diabetes and dyslipidemia, the WML volume increased in those aged ＜50 years (β [95%CI] = 376.5 [209.3-543.8] and β [95%CI] = 154.0 [93.0-215.0], respectively). Current smoking showed an increase in those aged 50-59 and ≥ 60 years (β [95%CI] = 104.5 [2.1-206.8] and β [95%CI] = 305.9 [133.4-478.5], respectively). No significant associations were observed for any CVD risk factors in the other age groups.
Conclusions:
The WML volume changes were larger in younger age groups for most CVD risk factors, suggesting that early management of these factors may help prevent WML progression.
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