title: Cerebral microbleeds are associated with deep white matter hyperintensities, but only in hypertensive patients.
abstract: Cerebral microbleeds (CMBs) and white matter hyperintensities (WMH) are the most common manifestations of small vessel disease, and often co-occur in patients with cerebral vascular disease. Hypertension is widely accepted as a risk factor for both CMBs and WMH. However, the effect of hypertension on the association between CMBs and WMH remains unclear. We hypothesized that the relationship between CMBs and WMH is determined by hypertension. One hundred forty-eight patients with acute cerebrovascular disease who were admitted to PLA general hospital in Beijing, China from February 2010 to May 2011 were recruited in this study. CMBs on T2*-weighted angiography (SWAN) were assessed using the Brain Observer Microbleed Rating Scale criteria. The severity of the WMH was separately assessed as either peri-ventricular hyperintensities (PVH) or deep white matter hyperintensities (DWMH). The association among CMBs and the severity of WMH, and hypertension were determined. CMBs were found in 65 (43.9%) patients. The frequency of CMBs was related to the severity of DWMH and PVH. CMBs were more frequently observed in patients with hypertension compared to patients without hypertension (51.3% vs. 20.0%, p = 0.001). Hypertension was an independent risk factor for CMBs (odds ratio 5.239, p = 0.001) and DWMH (odds ratio 2.373, p = 0.040). Furthermore, the relationship between the presence of CMBs and the severity of DWMH was only found in patients with hypertension (r = 0.298, p<0.01). However, CMBs were associated with PVH independently of hypertension. This study demonstrated that hypertension determined the association between CMBs and DWMH.
authors.affiliation: Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Zhongbao
authors.initials: Z
authors.lastname: Gao
authors.affiliation: Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Zhenfu
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Xingli
authors.initials: X
authors.lastname: Zhao
authors.affiliation: Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Yanchang
authors.initials: Y
authors.lastname: Shang
authors.affiliation: Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Yaner
authors.initials: Y
authors.lastname: Guo
authors.affiliation: Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Mei
authors.initials: M
authors.lastname: Gong
authors.affiliation: Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Lijuan
authors.initials: L
authors.lastname: Yang
authors.affiliation: Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Xiaobing
authors.initials: X
authors.lastname: Shi
authors.affiliation: Department of Radiology, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Xian
authors.initials: X
authors.lastname: Xu
authors.affiliation: Department of Radiology, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Ningyu
authors.initials: N
authors.lastname: An
authors.affiliation: Department of Geriatric Neurology, Chinese PLA General Hospital, Beijing, People's Republic of China.
authors.forename: Weiping
authors.initials: W
authors.lastname: Wu
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001794:Blood Pressure; D001921:Brain / Q000473:pathology*; D020520:Brain Infarction / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000150:complications*; D002561:Cerebrovascular Disorders / Q000473:pathology; D002681:China; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D020521:Stroke / Q000473:pathology; D066127:White Matter / Q000473:pathology*