title: Prevalence of Intracranial Atherosclerotic Stenosis Using High-Resolution Magnetic Resonance Angiography in the General Population: The Atherosclerosis Risk in Communities Study.
abstract: Intracranial atherosclerotic stenosis (ICAS) is a common cause of stroke, but little is known about its epidemiology. We studied the prevalence of ICAS and its association with vascular risk factors using high-resolution magnetic resonance angiography in a US cardiovascular cohort.
  
  
  
  The Atherosclerosis Risk in Communities (ARIC) study recruited participants from 4 US communities from 1987 to 1989. Using stratified sampling, we selected 1980 participants from visit 5 (2011-2013) for high-resolution 3T-magnetic resonance angiography. All images were analyzed in a centralized laboratory, and ICAS was graded as: no stenosis, <50% stenosis, 50% to 69% stenosis, 70% to 99% stenosis, and complete occlusion. We calculated per-vessel and per-person prevalence of ICAS (weighted for n=6538 visit 5 participants) and also estimated the US prevalence. We used multivariable logistic regression to identify variables independently associated with ICAS.
  
  
  
  Subjects who had an adequate magnetic resonance angiography (n=1765) were aged 67 to 90 years, 41% were men, 70% were white, and 29% were black. ICAS was prevalent in 31% of participants and 9% had ICAS ≥50%. Estimated US prevalence of ICAS ≥50% for 65 to 90 years old was 8% for whites and 12% for blacks. Older age, black race, higher systolic blood pressure, and higher low-density lipoprotein cholesterol levels were associated with increased odds of ICAS, whereas higher levels of high-density lipoprotein cholesterol and use of cholesterol-lowering medications were associated with decreased odds of ICAS. Body mass index and smoking were not associated with ICAS.
  
  
  
  The prevalence of ICAS in older adults is high, and it could be a target for primary prevention of stroke and dementia in this population.
authors.affiliation: From the Department of Neurology (M.F.K.S., A.I.Q.), Division of Epidemiology and Community Health, School of Public Health (A.A., A.R.F.), and Division of Biostatistics, School of Public Health (X.M., J.Z., H.C.), University of Minnesota, Minneapolis; Departments of Epidemiology (E.G., L.L.) and Medicine (E.G., L.L.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Y.Z.); and The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD (Y.Q., B.A.W.). Suri0027@umn.edu.
authors.forename: Muhammad Fareed K
authors.initials: MF
authors.lastname: Suri
authors.affiliation: From the Department of Neurology (M.F.K.S., A.I.Q.), Division of Epidemiology and Community Health, School of Public Health (A.A., A.R.F.), and Division of Biostatistics, School of Public Health (X.M., J.Z., H.C.), University of Minnesota, Minneapolis; Departments of Epidemiology (E.G., L.L.) and Medicine (E.G., L.L.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Y.Z.); and The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD (Y.Q., B.A.W.).
authors.forename: Ye
authors.initials: Y
authors.lastname: Qiao
authors.affiliation: From the Department of Neurology (M.F.K.S., A.I.Q.), Division of Epidemiology and Community Health, School of Public Health (A.A., A.R.F.), and Division of Biostatistics, School of Public Health (X.M., J.Z., H.C.), University of Minnesota, Minneapolis; Departments of Epidemiology (E.G., L.L.) and Medicine (E.G., L.L.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Y.Z.); and The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD (Y.Q., B.A.W.).
authors.forename: Xiaoye
authors.initials: X
authors.lastname: Ma
authors.affiliation: From the Department of Neurology (M.F.K.S., A.I.Q.), Division of Epidemiology and Community Health, School of Public Health (A.A., A.R.F.), and Division of Biostatistics, School of Public Health (X.M., J.Z., H.C.), University of Minnesota, Minneapolis; Departments of Epidemiology (E.G., L.L.) and Medicine (E.G., L.L.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Y.Z.); and The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD (Y.Q., B.A.W.).
authors.forename: Eliseo
authors.initials: E
authors.lastname: Guallar
authors.affiliation: From the Department of Neurology (M.F.K.S., A.I.Q.), Division of Epidemiology and Community Health, School of Public Health (A.A., A.R.F.), and Division of Biostatistics, School of Public Health (X.M., J.Z., H.C.), University of Minnesota, Minneapolis; Departments of Epidemiology (E.G., L.L.) and Medicine (E.G., L.L.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Y.Z.); and The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD (Y.Q., B.A.W.).
authors.forename: Jincheng
authors.initials: J
authors.lastname: Zhou
authors.affiliation: From the Department of Neurology (M.F.K.S., A.I.Q.), Division of Epidemiology and Community Health, School of Public Health (A.A., A.R.F.), and Division of Biostatistics, School of Public Health (X.M., J.Z., H.C.), University of Minnesota, Minneapolis; Departments of Epidemiology (E.G., L.L.) and Medicine (E.G., L.L.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Y.Z.); and The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD (Y.Q., B.A.W.).
authors.forename: Yiyi
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: From the Department of Neurology (M.F.K.S., A.I.Q.), Division of Epidemiology and Community Health, School of Public Health (A.A., A.R.F.), and Division of Biostatistics, School of Public Health (X.M., J.Z., H.C.), University of Minnesota, Minneapolis; Departments of Epidemiology (E.G., L.L.) and Medicine (E.G., L.L.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Y.Z.); and The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD (Y.Q., B.A.W.).
authors.forename: Li
authors.initials: L
authors.lastname: Liu
authors.affiliation: From the Department of Neurology (M.F.K.S., A.I.Q.), Division of Epidemiology and Community Health, School of Public Health (A.A., A.R.F.), and Division of Biostatistics, School of Public Health (X.M., J.Z., H.C.), University of Minnesota, Minneapolis; Departments of Epidemiology (E.G., L.L.) and Medicine (E.G., L.L.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Y.Z.); and The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD (Y.Q., B.A.W.).
authors.forename: Haitao
authors.initials: H
authors.lastname: Chu
authors.affiliation: From the Department of Neurology (M.F.K.S., A.I.Q.), Division of Epidemiology and Community Health, School of Public Health (A.A., A.R.F.), and Division of Biostatistics, School of Public Health (X.M., J.Z., H.C.), University of Minnesota, Minneapolis; Departments of Epidemiology (E.G., L.L.) and Medicine (E.G., L.L.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Y.Z.); and The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD (Y.Q., B.A.W.).
authors.forename: Adnan I
authors.initials: AI
authors.lastname: Qureshi
authors.affiliation: From the Department of Neurology (M.F.K.S., A.I.Q.), Division of Epidemiology and Community Health, School of Public Health (A.A., A.R.F.), and Division of Biostatistics, School of Public Health (X.M., J.Z., H.C.), University of Minnesota, Minneapolis; Departments of Epidemiology (E.G., L.L.) and Medicine (E.G., L.L.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Y.Z.); and The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD (Y.Q., B.A.W.).
authors.forename: Alvaro
authors.initials: A
authors.lastname: Alonso
authors.affiliation: From the Department of Neurology (M.F.K.S., A.I.Q.), Division of Epidemiology and Community Health, School of Public Health (A.A., A.R.F.), and Division of Biostatistics, School of Public Health (X.M., J.Z., H.C.), University of Minnesota, Minneapolis; Departments of Epidemiology (E.G., L.L.) and Medicine (E.G., L.L.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Y.Z.); and The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD (Y.Q., B.A.W.).
authors.forename: Aaron R
authors.initials: AR
authors.lastname: Folsom
authors.affiliation: From the Department of Neurology (M.F.K.S., A.I.Q.), Division of Epidemiology and Community Health, School of Public Health (A.A., A.R.F.), and Division of Biostatistics, School of Public Health (X.M., J.Z., H.C.), University of Minnesota, Minneapolis; Departments of Epidemiology (E.G., L.L.) and Medicine (E.G., L.L.), Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD; Departments of Epidemiology and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD (Y.Z.); and The Russell H. Morgan Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD (Y.Q., B.A.W.).
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Wasserman
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003251:Constriction, Pathologic / Q000000981:diagnostic imaging / Q000453:epidemiology; D005260:Female; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D018810:Magnetic Resonance Angiography / Q000379:methods*; D008297:Male; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: intracranial atherosclerosis stenosis; intracranial stenosis; magnetic resonance angiography; prevalence