[Association of hypertension and diabetes mellitus with microangiopathic cerebral infarct patterns].
OBJECTIVE
To test the hypothesis of a positive association of hypertension and diabetes mellitus with cerebral small-vessel disease infarct patterns.


METHODS
Using a prospective stroke database, the 152 patients with computertomographic signs of small-vessel disease (lacunes and/or leucoaraiosis)--including as a subgroup of 85 cases with multiple lacunes and/or leucoaraiosis-were compared with 106 patients featuring pial artery infarcts. Statistical analyses of the rates of hypertension and diabetes included univariate tests (odds ratios) and a logistic regression model comprising the additional variables hypercholesterolemia, cigarette smoking, carotid stenosis, atrial fibrillation, and left cardiac thrombus.


RESULTS
Multivariate testing revealed a significant association of hypertension and diabetes with multiple lacunar infarcts and/or leucoaraiosis (hypertension: odds ratio 2.0; 95% confidence interval 1.04-3.7; diabetes: odds ratio 1.9; 95% confidence interval 1.01-3.8), whereas for the total group of patients with small-vessel disease lesions no such effect was found. Among the other tested variables, only atrial fibrillation/left cardiac thrombus showed a significant negative association (odds ratio 0.5; 95% confidence interval 0.2-0.9) with lacunes/leucoaraiosis.


CONCLUSIONS
Independent of other risk factors and other possible causes of stroke, both hypertension and diabetes appear to be strong determinants of multiple lacunar infarcts and/or leucoaraiosis.
Mast
H
H
Neurologische Klinik, Universitätsklinikum Benjamin Franklin, Freie Universität Berlin.
Koennecke
H C
HC
Hartmann
A
A
Stapf
C
C
Marx
P
P
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000209:etiology; D003925:Diabetic Angiopathies / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000175:diagnosis*; D007256:Information Systems; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors