title: A high normal ankle-brachial index combined with a high pulse wave velocity is associated with cerebral microbleeds.
abstract: Arterial stiffness is associated with the pathogenesis of cerebral microbleeds (CMBs). The ankle-brachial index (ABI) is used to predict arterial stiffness. We hypothesized that the increase in ABI with age occurs as a result of increasing arterial stiffness and wave reflection, and is thus associated with target organ damage. The aim of this study was to investigate the relationship between ABI, brachial-ankle pulse wave velocity (baPWV), and CMBs.
  
  
  
  We recruited 990 cardiovascular disease-free and stroke-free participants [median age 53 (24-86) years, 531 were woman] who underwent brain MRI, ABI, and baPWV at a health checkup.
  
  
  
  The prevalence of CMBs was 4%. Both ABI (1.14 vs. 1.10) and baPWV (17.29 vs. 14.68 m/s) were higher in participants with CMBs than those without. Cutoff values of ABI and baPWV for the presence of CMBs were 1.12 and 16.07 m/s, respectively. Multivariate logistic regression analysis showed that ABI at least 1.12 [odds ratio (OR) 2.57, 95% confidence interval (CI) 1.30-5.37, P < 0.05] and baPWV at least 16.07 m/s (OR 2.08, 95% CI 1.02-4.38, P < 0.05) were independently associated with CMBs. Moreover, the combination of ABI at least 1.12 and baPWV at least 16.07 m/s was strongly associated with CMBs (OR 5.26, 95% CI 1.93-16.92, P < 0.05).
  
  
  
  A high normal ABI, combined with a high baPWV, was strongly associated with CMBs in a screened Japanese cohort, suggesting a novel use for ABI as a predictor for target organ damage.
authors.affiliation: aDepartment of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus Graduate School of Medicine bOkinawa Health Promotion Foundation, Okinawa, Japan.
authors.forename: Yoshino
authors.initials: Y
authors.lastname: Kinjo
authors.forename: Akio
authors.initials: A
authors.lastname: Ishida
authors.forename: Kozen
authors.initials: K
authors.lastname: Kinjo
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Ohya
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D055109:Ankle Brachial Index; D001921:Brain / Q000000981:diagnostic imaging; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D015995:Prevalence; D063177:Pulse Wave Analysis; D059289:Vascular Stiffness; D055815:Young Adult