Vascular risk factors, atherosclerosis, cerebral white matter lesions and cerebral perfusion in a population-based study.
We studied risk factors for cerebral vascular disease (blood pressure and hypertension, factor VIIc, factor VIIIc, fibrinogen), indicators of atherosclerosis (intima-media thickness and plaques in the carotid artery) and cerebral white matter lesions in relation to regional cerebral blood flow (rCBF) in 60 persons (aged 65-85 years) recruited from a population-based study. rCBF was assessed with single-photon emission tomography using technetium-99m d, l-hexamethylpropylene amine oxime (99mTc-HMPAO). Statistical analysis was performed with multiple linear regression with adjustment for age, sex and ventricle-to-brain ratio. A significant positive association was found between systolic and diastolic blood pressure and temporo-parietal rCBF. In analysis with quartiles of the distribution, we found a threshold effect for the relation of low diastolic blood pressure (</=60 mmHg) and low temporo-parietal rCBF. Levels of plasma fibrinogen were inversely related to parietal rCBF, with a threshold effect of high fibrinogen levels (>3.2 g/l) and low rCBF. Increased atherosclerosis was related to low rCBF in all cortical regions, but these associations were not significant. No consistent relation was observed between severity of cerebral white matter lesions and rCBF. Our results may have implications for blood pressure control in the elderly population.
Claus
J J
JJ
Department of Epidemiology and Biostatistics, Erasmus University Medical School, Rotterdam, The Netherlands.
Breteler
M M
MM
Hasan
D
D
Krenning
E P
EP
Bots
M L
ML
Grobbee
D E
DE
van Swieten
J C
JC
van Harskamp
F
F
Hofman
A
A
D000368:Aged; D000369:Aged, 80 and over; D000941:Antigens / Q000032:analysis; D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D001927:Brain Diseases / Q000453:epidemiology*; D002339:Carotid Arteries / Q000000981:diagnostic imaging; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005167:Factor VII / Q000032:analysis; D005169:Factor VIII / Q000032:analysis; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006801:Humans; D006973:Hypertension / Q000453:epidemiology; D002537:Intracranial Arteriosclerosis / Q000453:epidemiology*; D016014:Linear Models; D008279:Magnetic Resonance Imaging; D008297:Male; D015609:Organotechnetium Compounds; D010091:Oximes; D012307:Risk Factors; D012494:Sampling Studies; D019690:Technetium Tc 99m Exametazime; D015899:Tomography, Emission-Computed, Single-Photon; D014463:Ultrasonography
D000941:Antigens; D015609:Organotechnetium Compounds; D010091:Oximes; C042580:factor VII clotting antigen; D019690:Technetium Tc 99m Exametazime; D005167:Factor VII; D005169:Factor VIII; D005340:Fibrinogen