PS-BPP03-6: HIGHER ARTERIAL STIFFNESS IS ASSOCIATED WITH SILENT CEREBRAL SMALL VESSEL DISEASE IRRESPECTIVE OF BLOOD PRESSURE

Abstract

Objectives: Arterial stiffness and hypertension are important risk factors for cerebral small vessel diseases (CSVD). Arterial stiffness assessed by pulse wave velocity (PWV) is closely related with hypertension. Higher PWV represents an organ damage from hypertension. However, there are hypertensive patients with lower PWV and non-hypertensive subjects with higher PWV in clinical practice. The aim of the study is to determine the impact of PWV on CSVD in non-hypertensive and hypertensive individuals. Design and method: An observational cross-sectional study was conducted in 1894 stroke-free participants who underwent a brain magnetic resonance imaging and brachial-ankle PWV (baPWV) at a health checkup between 2013 and 2020. baPWV were measured using an automatic oscillometric device. The presence of CSVD, including white matter hyperintensities, cerebral microbleeds, silent lacunar infarcts, and dilated periventricular spaces, were determined by brain magnetic resonance imaging. Participants were divided into 4 groups according to blood pressure (BP, 120/80 mmHg) and baPWV (14.63 m/s, a cutoff value that predicted the presence of CSVD). Results: The mean age was 57 years (41% women). The prevalence of CSVD was 718 (38%), and it was higher in low BP with high baPWV group (56%) and high BP with high baPWV group (55%) compared to high BP with low baPWV group (24%) and low BP with low baPWV group (22%). Both low BP with high baPWV group (odds ratio 1.89; 95% CI, 1.00–3.56) and high BP with high baPWV group (odds ratio 2.12; 95% CI, 1.41–3.21), but not high BP with low baPWV group (odds ratio 1.19, 95% CI 0.76–1.86), had significantly higher odds ratio for the presence of CSVD compared with low BP with low baPWV group, after adjustment for age, sex, and other conventional risk factors, and use of any agents for hypertension, dyslipidemia, and diabetes. Conclusions: Individuals with high baPWV had higher prevalence of CSVD, irrespective of BP status. It is likely that higher arterial stiffness is an important risk for CSVD in stroke-free healthy populations.