Abstract 180: Carotid Artery Stiffness and the Development of White Matter Hyperintensities Over a 20-Year Period: A Secondary Analysis of the ARIC Study

Abstract

Introduction: Arterial stiffness is a biomarker of cerebrovascular disease risk. Prior reports have shown an association between concurrent measurements of carotid artery stiffness and white matter hyperintensity (WMH). Hypothesis: Carotid artery stiffness will accurately predict WMH burden on MRI performed 20 years later in the Atherosclerosis Risk in the Community (ARIC) study. Methods: We included ARIC patients with carotid stiffness on ultrasound at Visit 2 (1990-1992) and brain MRI with volumetric WMH at Visit 5 (2011-2013). The primary outcome is WMH in cm 3 and the secondary is WMH as a percentage of intrapatient total brain volume. The predictor is carotid stiffness, which is the inverse of the validated ultrasound measurement of Arterial Distensibility, divided into quintiles. Results: Inclusion criteria were met by 1,404 patients (41% male), aged 55.6±5.3 years at the ultrasound and 76.3±5.4 years at the MRI. Carotid stiffness was highly correlated with WMH volume and WMH volume after adjustment for total brain volume (Table 1). This association persisted in a multivariate model (Table 2) and is linear in nature (Figure 1). Conclusion: Carotid stiffness is an accurate predictor of WMH volume measured 20 years later. This biomarker could prove informative for future studies seeking to delay WMH progression.