RT Journal Article
SR Electronic
T1 Asymptomatic cerebral small vessel disease in adults with low cardiovascular risk
JF BMJ Neurology Open
JO BMJ Neurol Open
FD BMJ Publishing Group Ltd
SP e000356
DO 10.1136/bmjno-2022-000356
VO 5
IS 1
A1 Zenaida Milagros Hernández-Díaz
A1 Marisol Peña-Sánchez
A1 Mayelin Pimienta-Medina
A1 Sergio González-García
A1 Marta Brown Martínez
A1 Marianela Arteche Prior
A1 Yasmany Martin Arias
A1 Edwin Humberto Hodelin-Maynard
A1 Armando Abreu Duque
A1 Alina Gonzalez-Quevedo
YR 2023
UL http://neurologyopen.bmj.com/content/5/1/e000356.abstract
AB Introduction Cerebral small vessel disease (CSVD) frequently occurs in individuals with vascular risk factors. This condition might go unrecognised or result in only mild functional deficits.Objective To evaluate the relationship between cardiovascular (CV) risk calculated with the HEARTS app and CSVD burden in a population without cardio-cerebrovascular diseases, and to estimate the prevalence of CSVD in low risk (LR) individuals.Methods Asymptomatic subjects with vascular risk factors were included from primary health areas in Havana. The WHO’s revised CV disease risk prediction chart (HEARTS app) was applied to all individuals, who were classified into two groups: LR and moderate/high risk (M/HR). Brain MRI was performed in all subjects.Results 170 patients were included: 43 (25.3%) classified as low CV risk and 127 (74.7%) had M/HR CV risk. Half of the neurologically healthy individuals included displayed cerebral small vessel involvement (51.2%). White matter hyperintensities (WMH) and enlarged perivascular spaces were the most frequent lesions observed in both groups. WMH were more severe and more severe global score for CSVD were more frequent in the M/HR group (57.5%). It was noteworthy that 32.6% of LR-patients also exhibited more severe CSVD. The multivariate regression analysis revealed an independent association of arterial hypertension and age with the severity of CSVD.Conclusions CV risk stratification through the HEARTS app has limited utility for predicting brain health in individuals with low CV risk. Identifying silent CSVD in individuals with apparently low CV risk is important, especially if they suffer from arterial hypertension.Data are available on reasonable request. All data relevant to the study are included in the article or uploaded as online supplemental information.