title: Increased brachial-ankle pulse wave velocity is independently associated with white matter hyperintensities.
abstract: BACKGROUND
  White matter hyperintensities (WMHs) are a risk factor for stroke. Their etiology is considered to be cerebral microvascular abnormality. However, the association between WMHs and arteriosclerosis is not yet clear. The aim of this hospital-based cohort study was to identify the arteriosclerotic characteristics associated with WMHs.
  
  
  METHODS
  We cross-sectionally included 240 consecutive patients with no history of stroke. We measured the brachial-ankle pulse wave velocity (baPWV), ankle brachial pressure index, and intima-media thickness of the common carotid artery, and we performed magnetic resonance brain imaging. WMHs were defined as periventricular hyperintensity (Fazekas grade ≥3) and/or separate deep white matter hyperintense signals (Fazekas grade ≥2). We determined the prevalence of WMHs, silent brain infarction (SBI), hypertension, hypercholesterolemia, diabetes mellitus, ischemic heart disease, and smoking. We compared 2 groups of patients, defined by the presence or absence of WMHs, using multiple logistic regression analyses.
  
  
  RESULTS
  In multivariable analysis, SBI (OR 3.38; 95% CI 1.52-7.72), hypertension (OR 2.23; 95% CI 1.03-5.15), female sex (OR 1.95; 95% CI 1.03-3.76), baPWV (OR 1.12; 95% CI 1.02-1.23), and age (OR 1.09; 95% CI 1.04-1.14) were independently associated with WMHs.
  
  
  CONCLUSIONS
  An increased baPWV is associated with WMHs. Management of increased baPWV may help to prevent the progression of WMHs and stroke.
authors.affiliation: Department of Neurology, Hyogo Brain and Heart Center at Himeji, Himeji, Japan. sajink@nifty.com
authors.forename: Naoki
authors.initials: N
authors.lastname: Saji
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Shimizu
authors.forename: Toshitaka
authors.initials: T
authors.lastname: Kawarai
authors.forename: Makoto
authors.initials: M
authors.lastname: Tadano
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Kita
authors.forename: Koichi
authors.initials: K
authors.lastname: Yokono
mesh_terms: D000368:Aged; D055109:Ankle Brachial Index / Q000379:methods* / Q000706:statistics & numerical data; D001783:Blood Flow Velocity; D001921:Brain / Q000473:pathology*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional / Q000379:methods; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D009413:Nerve Fibers, Myelinated / Q000473:pathology*; D016017:Odds Ratio; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography