Association between cardiovascular disease risk factors and white matter lesions: The Tohoku Medical Megabank Cohort Study

Abstract

Aim: White matter lesions (WML) are associated with dementia and they are influenced by cardiovascular disease (CVD) risk factors. Managing these risk factors may prevent WML progression. However, few longitudinal studies have examined the association between CVD risk factors and changes in the WML volume. This study aimed to investigate this association across a broad age range, including younger individuals.

Methods: This longitudinal study included 4,595 participants (age range, 21–90 years; women, 61.7%) who underwent brain magnetic resonance imaging. WML was defined on T1-weighted images. The associations between each CVD risk factor (hypertension, diabetes, dyslipidemia, and current smoking) and WML volume changes (per 4 years) were analyzed using a generalized linear model with estimated regression coefficients (β) and 95% confidence intervals (CI). The analyses were stratified by age group (＜50, 50–59, 60–69, and ≥ 70 years).

Results: Hypertension was significantly associated with increased WML volume change in those aged ＜50 and 50–59 years (β [95%CI] = 57.1 [8.0–106.2] and β [95%CI] = 77.9 [6.8–149.0], respectively). For both diabetes and dyslipidemia, the WML volume increased in those aged ＜50 years (β [95%CI] = 376.5 [209.3–543.8] and β [95%CI] = 154.0 [93.0–215.0], respectively). Current smoking showed an increase in those aged 50–59 and ≥ 60 years (β [95%CI] = 104.5 [2.1–206.8] and β [95%CI] = 305.9 [133.4–478.5], respectively). No significant associations were observed for any CVD risk factors in the other age groups.

Conclusions: The WML volume changes were larger in younger age groups for most CVD risk factors, suggesting that early management of these factors may help prevent WML progression.