title: Mechanical stresses, arterial stiffness, and brain small vessel diseases: Shimanami Health Promoting Program Study.
abstract: OBJECTIVE
  Arterial stiffness, a risk factor of brain small vessel diseases (SVD), causes hemodynamic changes. Mechanical stresses, circumferential wall tension (WT), and shear stress (SS) may change with arterial stiffness and be related to SVD. We investigated the associations between mechanical stresses and arterial stiffness and SVD.
  
  
  METHODS
  A total of 1296 subjects without apparent cardiovascular diseases were recruited. Brachial-to-ankle pulse wave velocity (baPWV) was measured as an arterial stiffness index. Silent lacunar infarction and deep subcortical white matter hyperintensity were evaluated as SVD indices. Circumferential WT and SS at peak systole and end diastole were measured at the common carotid artery. Second peak of systolic blood pressure was obtained from the radial waveform and used as a central systolic blood pressure substitute.
  
  
  RESULTS
  baPWV was associated positively with WT (P<0.0001) and negatively with SS (P=0.0007) even after correction for confounding parameters including baPWV. SVD was associated with significantly higher WT (P<0.0001) and lower SS (P<0.0001). After adjustment for confounding parameters (including baPWV), second peak of systolic blood pressure WT (odds ratio, 1.30; P=0.0017) and end diastolic WT (odds ratio, 1.60; P=0.0038) were related to presence of silent lacunar infarction, whereas peak systolic (odds ratio, 0.95; P=0.014) and end diastolic SS (odds ratio, 0.94; P=0.014) were associated with presence of deep subcortical white matter hyperintensity grade >3. Regression lines between blood pressure and WT were significantly steeper in subjects with SVD than without SVD (β=0.02; P<0.0001).
  
  
  CONCLUSIONS
  These findings indicate that SVD is phenotype-specifically associated with alterations in WT and SS independently of arterial stiffness.
authors.affiliation: From the Department of Geriatrics and Neurology, Ehime University Graduate School of Medicine, Toon-City, Ehime, Japan (Y.O., K.K., M.O., T.N., M.I., T.M.); and Department of Medical Genetics, Kyoto University Graduate School of Medicine, Kyoto, Japan (Y.T.).
authors.forename: Yoko
authors.initials: Y
authors.lastname: Okada
authors.affiliation: From the Department of Geriatrics and Neurology, Ehime University Graduate School of Medicine, Toon-City, Ehime, Japan (Y.O., K.K., M.O., T.N., M.I., T.M.); and Department of Medical Genetics, Kyoto University Graduate School of Medicine, Kyoto, Japan (Y.T.). koharak@m.ehime-u.ac.jp.
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Kohara
authors.affiliation: From the Department of Geriatrics and Neurology, Ehime University Graduate School of Medicine, Toon-City, Ehime, Japan (Y.O., K.K., M.O., T.N., M.I., T.M.); and Department of Medical Genetics, Kyoto University Graduate School of Medicine, Kyoto, Japan (Y.T.).
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ochi
authors.affiliation: From the Department of Geriatrics and Neurology, Ehime University Graduate School of Medicine, Toon-City, Ehime, Japan (Y.O., K.K., M.O., T.N., M.I., T.M.); and Department of Medical Genetics, Kyoto University Graduate School of Medicine, Kyoto, Japan (Y.T.).
authors.forename: Tokihisa
authors.initials: T
authors.lastname: Nagai
authors.affiliation: From the Department of Geriatrics and Neurology, Ehime University Graduate School of Medicine, Toon-City, Ehime, Japan (Y.O., K.K., M.O., T.N., M.I., T.M.); and Department of Medical Genetics, Kyoto University Graduate School of Medicine, Kyoto, Japan (Y.T.).
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Tabara
authors.affiliation: From the Department of Geriatrics and Neurology, Ehime University Graduate School of Medicine, Toon-City, Ehime, Japan (Y.O., K.K., M.O., T.N., M.I., T.M.); and Department of Medical Genetics, Kyoto University Graduate School of Medicine, Kyoto, Japan (Y.T.).
authors.forename: Michiya
authors.initials: M
authors.lastname: Igase
authors.affiliation: From the Department of Geriatrics and Neurology, Ehime University Graduate School of Medicine, Toon-City, Ehime, Japan (Y.O., K.K., M.O., T.N., M.I., T.M.); and Department of Medical Genetics, Kyoto University Graduate School of Medicine, Kyoto, Japan (Y.T.).
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Miki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000098:blood supply / Q000473:pathology; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002561:Cerebrovascular Disorders / Q000175:diagnosis* / Q000453:epidemiology* / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006293:Health Promotion / Q000379:methods; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D063177:Pulse Wave Analysis / Q000379:methods; D012307:Risk Factors; D013314:Stress, Mechanical; D059289:Vascular Stiffness / Q000502:physiology*
keywords: brain small vessel disease; carotid artery; mechanical stress; vascular stiffness