scholarly journals Vascular Risk Factors and Findings on Brain MRI of Elderly Adult American Indians: The Strong Heart Study

2019 ◽  
Vol 52 (3-4) ◽  
pp. 173-180 ◽  
Author(s):  
Dean  Shibata ◽  
Astrid Suchy-Dicey ◽  
Cara L. Carty ◽  
Tara  Madhyastha ◽  
Tauqeer Ali ◽  
...  
Keyword(s):  
Risk Factors ◽  
American Indians ◽  
Brain Mri ◽  
Vascular Risk Factors ◽  
Elderly Adult ◽  
Vascular Risk ◽  
Strong Heart Study ◽  
Heart Study

Abstract P211: Prediction of Stroke in a Population with High Prevalence of Diabetes: The Strong Heart Study

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Ying Zhang ◽  
Wenyu Wang ◽  
Elisa T Lee ◽  
Thomas K Welty ◽  
Jorge R Kizer ◽  
...  
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
American Indians ◽  
Prediction Models ◽  
Model Performance ◽  
Prediction Equation ◽  
Prediction Equations ◽  
Strong Heart Study ◽  
Discrimination Ability ◽  
Heart Study

Background— Stroke prediction models are valuable to physicians in evaluating the risk of their patients so that preventive interventions can be promoted. The Framingham Risk Profile is a widely used stroke prediction equation. However, the contributions of some common risk factors for stroke vary across populations and some risk factors are specific to certain populations. For example, albuminuria is an important risk factor in American Indians (AIs), which is not included in the Framingham equation. The objective of the current study is to develop stroke prediction equations using routinely collected variables in AIs, a population with high rates of diabetes and stroke. Methods— The data used in the analysis are from 4507 stroke free participants at enrollment in the Strong Heart Study (SHS), the largest population-based longitudinal study of cardiovascular disease (CVD) and its risk factors in AIs in Arizona, Oklahoma, and South/North Dakota. As of December 2008, 379/4507 (8.4%) participants suffered a first stroke during an average follow-up of 17 years. Baseline potential risk factors were included in the Cox proportional-hazard models to develop gender-specific prediction equations. Backward selection was used to choose the predictors. Model performance was assessed using Harrell’s C statistics based on bootstrapping methods. Results— Baseline age, untreated systolic blood pressure, treated diastolic blood pressure, HDL-C, current smoking, diabetes, macro-albuminuria, and history of CVD are significant predictors for incident stroke among women. Most of these predictors except HDL-C were also in the prediction equation for men. The equations provided good discrimination ability, as indicated by a C statistic of 0.72 for men and 0.73 for women. Conclusions— Predicted risk of stroke in 10 years can be provided for physicians and their patients. Then appropriate intervention can be implemented. The stroke prediction equations from SHS can be applied to other AIs as well as other ethnic groups with high rates of diabetes and albuminuria.

Prevalence of hippocampal enlarged perivascular spaces in a sample of patients with hypertension and their relation with vascular risk factors and cognitive function

2018 ◽  
Vol 89 (6) ◽  
pp. 651-656 ◽  
Author(s):  
Joan Jiménez-Balado ◽  
Iolanda Riba-Llena ◽  
Edurne Garde ◽  
Marta Valor ◽  
Belen Gutiérrez ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Function ◽  
Rating Scale ◽  
Brain Mri ◽  
Treatment Compliance ◽  
Vascular Risk Factors ◽  
Study Cohort ◽  
Perivascular Spaces ◽  
Vascular Risk ◽  
Verbal Reasoning

ObjectivesThe clinical importance of hippocampal enlarged perivascular spaces (H-EPVS) remains uncertain. We aimed to study their association with vascular risk factors, cognitive function and mild cognitive impairment (MCI).MethodsData were obtained from the ISSYS (Investigating Silent Strokes in hYpertensives, a magnetic resonance imaging Study) cohort, which is a prospective study of patients with hypertension aged 50–70 with no prior stroke or dementia. Participants were clinically evaluated and underwent a cognitive screening test, Dementia Rating Scale-2, which includes five cognitive subscales (attention, initiation/perseveration, conceptualisation, construction and memory). Besides, they were diagnosed with MCI or normal ageing following standard criteria. H-EPVS were manually counted on brain MRI according to a previous scale and defined as extensive when H-EPVS count was ≥7 (upper quartile). Multivariate models were created to study the relationship between H-EPVS, vascular risk factors and cognitive function.Results723 patients were included; the median age was 64 (59–67) and 51% were male. Seventy-two patients (10%) were diagnosed with MCI and 612 (84.6%) had at least 1 H-EPVS. Older age (OR per year=1.04, 95% CI 1.01 to 1.08) and poor blood pressure treatment compliance (OR=1.50, 95% CI 1.07 to 2.11) were independently associated with extensive H-EPVS. Regarding cognitive function, H-EPVS were independently and inversely correlated with verbal reasoning (β=−0.021, 95% CI −0.038 to −0.003). No association was found between H-EPVS and MCI.ConclusionsH-EPVS are a frequent finding in patients with hypertension and are associated with ageing and poor hypertension treatment compliance. Besides, H-EPVS are associated with worse verbal reasoning function.

scholarly journals A Longitudinal Study of Risk Factors for Incident Albuminuria in Diabetic American Indians: The Strong Heart Study

2008 ◽  
Vol 51 (3) ◽  
pp. 415-424 ◽  
Author(s):  
Jiaqiong Xu ◽  
Elisa T. Lee ◽  
Richard B. Devereux ◽  
Jason G. Umans ◽  
Jonathan N. Bella ◽  
...  
Keyword(s):  
Risk Factors ◽  
Longitudinal Study ◽  
American Indians ◽  
Strong Heart Study ◽  
Heart Study

Vascular risk factors as predictors of epilepsy in older age: The Framingham Heart Study

Epilepsia ◽  
2021 ◽  
Author(s):  
Maria Stefanidou ◽  
Jayandra J. Himali ◽  
Orrin Devinsky ◽  
Jose R. Romero ◽  
Mohammad Arfan Ikram ◽  
...  
Keyword(s):  
Risk Factors ◽  
Framingham Heart Study ◽  
Vascular Risk Factors ◽  
Older Age ◽  
Vascular Risk ◽  
Heart Study

Abstract 51: Effects of Vascular Risk Factors on Microstructural White Matter: A Voxel-Based Longitudinal Diffusion Tensor Imaging Study

Stroke ◽  
2014 ◽  
Vol 45 (suppl_1) ◽  
Author(s):  
Pauline Maillard ◽  
Evan Fletcher ◽  
Owen Carmichael ◽  
Dan Mungas ◽  
Bruce Reed ◽  
...  
Keyword(s):  
Risk Factors ◽  
Diffusion Tensor Imaging ◽  
White Matter ◽  
Brain Aging ◽  
Diffusion Tensor ◽  
Brain Mri ◽  
Vascular Risk Factors ◽  
Vascular Risk ◽  
Local Contraction

Background: Diabetes mellitus type II (DMT2) and hypertension (HTN) have been reported as increasing the risk of dementia. Because recent cross-sectional diffusion tensor imaging (DTI) studies have identified association between vascular risk factors (VRF) and microstructural white matter (WM) abnormalities in elderly, longitudinal DTI studies are needed to determine whether VRF may be associated with accelerated WM degeneration over time. Methods: 114 cognitively normal participants from University of California, Davis Alzheimer’s Disease Center, aged 73.9±6.7, received a comprehensive clinical evaluation and brain MRI including T1-weighted and DTI sequences on two dates (mean delay: 3.3 years). Baseline and follow-up FA maps were calculated, aligned, and subtracted to provide FA change ([[Unable to Display Character: ∆]]FA) maps and warped to a common template (MDT). Coregistration of baseline and follow-up T1 maps to MDT enabled computation of Jacobian images (i.e. the local contraction factor). VRF score (VRFS) was computed as the sum of DMT2, HTN and hyperlipidemia (HYP) incidence based on the subject’s medical history. We then used voxel-based linear regressions to relate annual [[Unable to Display Character: ∆]]FA and Jacobian determinants to VRFS, adjusting for potential confounders. Resulting T maps were corrected for multiple comparisons. Results: Poorer VRF score was associated with higher rate of [[Unable to Display Character: ∆]]FA loss and of GM atrophy with regions most heavily implicated including the corpus callosum and the frontal GM (see Figure1). Conclusions: This is one of very few studies of longitudinal DTI change in the elderly. DMT2, HTH and HYP are associated with accelerated WM degeneration and GM atrophy in areas whose integrity is known to be reduced in mild cognitive impairment and dementia. Future work should clarify the independent role of these vascular risk factors in accelerating brain aging.

scholarly journals White Matter Hyperintensity in Different Migraine Subtypes

2021 ◽  
Author(s):  
Larisa A. Dobrynina ◽  
Anastasia D. Suslina ◽  
Mariia V. Gubanova ◽  
Anastasia V. Belopasova ◽  
Anastasia N. Sergeeva ◽  
...  
Keyword(s):  
Risk Factors ◽  
White Matter ◽  
Brain Mri ◽  
Vascular Complications ◽  
Diagnostic Value ◽  
Vascular Risk Factors ◽  
White Matter Hyperintensity ◽  
Control Group ◽  
Vascular Risk ◽  
Different Types

Abstract Background: The diagnostic value of white matter hyperintensities (WMH) in different types of migraine are unknown. Objective: To evaluate the WMH pattern of different subtypes in migraine patients with no vascular risk factors.Methods: 92 migraine patients (73 females, mean age 34.6±8.9; 61 episodic migraine, 31 chronic migraine, 36 migraine with aura, 56 migraine without aura) without vascular risk factors underwent brain MRI (3T). We also included a matched healthy control group with no migraine (n=24).Results: The prevalence of WMH in different types of migraine was similar and ranged from 38.7% to 44.4%; the control group showed no WMH at all. Lesions were located within frontal, parietal and temporal lobes (in order of decreasing incidence) in juxtacortical and/or deep white matter. WMH appeared as round or slightly elongated foci with a median size of 2.5 mm [1.5; 3]. Total number, size and prevalence of WMH by lobes and white matter regions were similar between groups, and no interaction with age or sex was found. The number of lesions within the frontal lobe juxtacortical white matter correlated with the age of patients (r= 0.331, p=0.001) and the duration since migraine onset (r=0.264, p=0.012). Conclusion: Patients with different migraine subtypes and without vascular risk factors are characterized by a similar pattern of WMH in the absence of subclinical infarctions or microbleedings. Therefore, WMH have no relevant prognostic value regarding the course of migraine and vascular complications. WMH pattern may be used to differentiate migraine as a primary disorder and other disorders with migraine-like headache and WMH.

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