Cerebral Small Vessel Disease Associated with Subclinical Vascular Damage Indicators in Asymptomatic Hypertensive Patients

• Published in: Behavioral sciences Vol. 9; no. 9; p. 91
• Main Authors: Hernández-Díaz, Zenaida Milagros, Peña-Sánchez, Marisol, González-Quevedo Monteagudo, Alina, González-García, Sergio, Arias-Cadena, Paula Andrea, Brown-Martínez, Marta, Betancourt-Loza, Mélany, Cordero-Eiriz, Anay
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 22-08-2019; MDPI
• Subjects: Asymptomatic; Blood pressure; Brain damage; brain lesions; Cardiovascular disease; Carotid arteries; cerebral small vessel disease; essential hypertension; Heart attacks; Hypertension; Magnetic resonance imaging; Risk factors; Ultrasonic imaging; Veins & arteries; white matter hyperintensities; Cuba; United States > US; essential hypertension; cerebral small vessel disease; risk factors; brain lesions; white matter hyperintensities
• ISSN: 2076-328X; 2076-328X
• DOI: 10.3390/bs9090091

: Cerebral small vessel disease (CSVD) is frequent in patients with cardiovascular risk factors including arterial hypertension, and it is associated with vascular damage in other organs and the risk of stroke, cognitive impairment, and dementia. Early diagnosis of CSVD could prevent deleterious consequences.
: To characterize CSVD associated with indicators of subclinical vascular damage in asymptomatic hypertensive patients.
: Participants were hypertensive (HT) and non-hypertensive (non-HT) individuals; without signs of cerebrovascular disease, dementia, and chronic renal failure. For CSVD, white matter hyperintensities (WMH), enlarged Virchow-Robin perivascular spaces (EVRPS), lacunar infarcts, and microbleeds were investigated. Subclinical vascular damage was evaluated (hypertensive retinopathy, microalbuminuria, and extracranial carotid morphology: intima media thickness (IMT) and atheroma plaque).
: CSVD MRI findings were more frequent in HT; as well as greater intimal thickening. The IMT + plaque was significantly associated with all MRI variables; but retinopathy was correlated with EVRPS and lacunar infarcts. Only microalbuminuria was related to the greater severity of WMH in HT. Multivariate analysis evidenced that CSVD was independently associated with the combination of indicators of vascular damage and systolic blood pressure.
: Combining indicators of subclinical vascular damage, such as carotid morphological variables, microalbuminuria, and hypertensive retinopathy for early detection of CSVD in asymptomatic hypertensive patients could prove to be useful to take actions for the prevention of irreversible brain damage, which could lead to cognitive impairment, dementia and stroke.