Background Stroke represents a common macrovascular complication among individuals with type 2 diabetes (T2DM). Carotid intima-media thickness (IMT) and carotid plaque (CP) serve as key indicators of cerebrovascular pathology. However, it is still unclear whether the associations of IMT and CP with stroke vary across different diabetic patient subgroups. We aimed to investigate the associations of IMT and CP with stroke in T2DM patients and further explored the subgroup variations. Methods In this cross-sectional study, 2,627 T2DM patients aged 32–80 years were enrolled. Baseline data including age, sex, anthropometrics, blood pressure, lipid profiles, smoking status, and medication use were collected. IMT and CP were measured by ultrasonography. Logistic regression analysis was used to evaluate their associations with stroke. Stratified and interaction analyses were performed to assess subgroup-specific variations. Results Among 2,627 enrolled participants, 51.8% reported CP, 17.8% had increased IMT (>=0.9mm), and 7.8% reported history of stroke. Multivariate analysis demonstrated that IMT and CP were differentially associated with risk for stroke. After adjustment for confounding variables, CP showed stronger associations with stroke (OR = 2.97, 95% CI: 2.04-4.33) compared to IMT. Stratified analyses showed that: (1) IMT had stronger associations with stroke in females (OR = 2.33), older patients (≥60 years) and diabetes duration >10 years; (2) CP showed stronger associations with stroke in males (OR = 3.44), younger patients (≤49 years), and patients with diabetes duration <5 years; (3) CP showed stronger association in smokers, while IMT had higher association with stroke in non-smokers. Conclusion Both of the two vascular markers IMT and CP showed associations with stroke in T2DM patients; however, there were significant subgroup variations. Individualized risk assessment in diabetic patients may have important clinical implications. All these findings warranted further prospective studies to confirm the subgroup-specific associations and establish causality.

Introduction. Heterozygous familial hypercholesterolemia (heFH) is a hereditary disease that leads to significantly elevated low-density lipoprotein cholesterol (LDL-C) levels developing from childhood. Aim. To determine independent predictors of common carotid intima-media thickness (CC-IMT) in children aged 6–18 years with familial hypercholesterolemia based on genetic, biochemical and behavioural factors. Materials and methods. A retrospective analytical case control study was conducted at the premises of GBUZ “Children’s City Clinical Hospital named after ZA Bashlyaeva, Moscow Department of Health” (Moscow). A complete analysis of electronic medical records of the Children’s Cardiology Centre patients for the period from January 2020 to March 2025 was performed. The total number of patients between 6 yr to 18 yr was 629; the treatment group (n = 471): 207/471 (43.9%) boys and 264/471 (56.1%) girls; the age of 12.6 [9.0-17.5] years — the patients with at-least-probable clinical or genetically confirmed diagnosis of FH according to the Simon-Broom criteria; the control group (n = 158): 76/158 (48.1%) boys and 82/158 (51.9%) girls; the age of 13.1 [11.2-15.5] years — patients of the same centre with excluded dyslipidemia based on the results of clinical and biochemical examinations. Patients in the control cohort were matched for gender and age, according to frequency. A comprehensive analysis of clinical, biochemical and behavioural factors determining early vascular ageing in children and adolescents with FH was performed. Results. A significant increase in the common carotid intima-media thickness (IMT) compared to the age-appropriate reference ranges was identified as early as at preschool and primary school age. Almost half of the boys and every fifth girl with FH by teen age (15–18 years) had an IMT greater than the 90th percentile of the reference range. The construction of a multivariate regression model allowed to explain 48% of the total variability of IMT. Pathogenic LDLR and APOB mutations, elevated levels of non-HDL cholesterol, lipoprotein (a), homocysteine, as well as smoking and low level of physical activity made the greatest contribution to the acceleration of vascular ageing. Conclusion. The authors emphasize that early identification of children with FH is critical, and the personalized approach to prescribing lipid-lowering therapy with due account for identified genetic and metabolic characteristics, and individual behavioural factors is required. This approach can help timely identify patients who are at highest risk of developing CVDs.

Relationship between HbA1c levels and thickness of carotid intima media in prediabetic and diabetic patients

Native and decellularized porcine vena cava: Histological analysis and in vitro repopulation.

Association between blood pressure trajectories and high carotid intima-media thickness in Chinese children.

Cardiovascular ageing involves changes such as arterial stiffening, myocardial remodelling, and systemic inflammation, which are linked to health decline, disease, and mortality. Despite advancements in understanding these mechanisms, establishing a concise and joined definition of cardiac and vascular ageing remains challenging. In this scoping review, we describe the key conceptual and operational definitions of cardiovascular ageing and propose a conceptual framework for understanding and defining the process. Current literature defines vascular ageing as the decline in arterial function and structure. Early vascular ageing refers to an accelerated deterioration, whereas healthy vascular ageing or supernormal vascular ageing describes individuals with exceptionally favourable vascular profiles. Key biomarkers for vascular ageing include pulse wave velocity measurements and carotid intima-media thickness, though definitions and cut-offs vary. In the context of cardiac ageing, NT-proBNP, high-sensitivity C-reactive protein, and high-sensitivity cardiac troponin T are highlighted for their potential to enhance risk prediction and clinical management. Combining these measurements into a comprehensive cardiovascular ageing score could provide more comprehensive assessments of cardiovascular health. Future research should aim to validate these definitions and biomarkers across diverse populations to establish robust reference values, refine prediction models, and improve the early identification and intervention of individuals at risk. Improving our ability to measure and understand cardiovascular ageing will enable us to better identify at-risk individuals and implement targeted interventions to mitigate cardiovascular risks early in the lifespan.

DECODE: An open-source cloud-based platform for the noninvasive management of peripheral artery disease.

Homozygous familial hypercholesterolemia (HoFH) is a rare inherited condition associated with extremely elevated levels of total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C), leading to early vascular atherosclerosis. Here we report a clinical observation of a girl with early-onset multiple xanthomatosis (the age of clinical symptom onset was 1.5 years) and a genetically confirmed homozygous variant, c.1729T>C, in the LDLR gene (p.W577R). The diagnosis was established at the age of 3 (TC up to 25 mmol/L; TC level time profile remained at 23.5 mmol/L, LDL-C 22.1 mmol/L). However, a targeted lipidlowering diet was not arranged in a consistent manner, and the drug therapy was not conducted, which reflected physicians' poor awareness and lack of routing of patients. The patient has been followed at the Z. A. Bashlyaeva Children's City Clinical Hospital of the Moscow Health Department (Competence Center for Screening and Treatment of Lipid Disorders in Children and Adolescents) since the age of 6.5 years. All attempts to choose any beneficial combination lipid-lowering pharmacotherapy (rosuvastatin, ezetimibe, evolocumab) have not yielded a clinically significant effect. Due to refractory hyperlipidemia, regular therapeutic apheresis (1–3 procedures per month; 62 sessions by July 2025) was initiated on December 22, 2022, which resulted in acute decreases in total cholesterol and LDL-cholesterol by 40–70% after each procedure. Significant regression of xanthomatosis, a decrease in the intima-media thickness of the common carotid arteries, coronary artery stabilization, and achievement of target blood pressure values were observed. This case stresses the utmost importance of early routing of patients, family screening, and combined treatment with high-intensity pharmacotherapy and regular lipoprotein apheresis to reduce cholesterol deposits on any part of the body in patients with impaired mechanisms of clearance of cholesterol and to stabilize vascular changes in children with HoFH.

Telomere length is associated with arterial damage in the CORDIOPREV study.

Type 2 diabetes mellitus (T2DM) presents a global health burden with cardiovascular disease (CVD) as its leading cause of mortality. A rapid clinical-adaptable microfluidic workflow for label-free CVD risk profiling based on neutrophil biophysical abnormalities is developed. This high-throughput single cell (>1,000 cellsmin-1) "electro-mechano-phenotyping" method integrates Uniform Manifold Approximation and Projectionanalysis to assess leukocyte biophysical changes (size, deformability, and impedance properties) linked to inflammation, thrombosis, and hyperglycemia in vitro, and in diabetic and diabetic atherosclerosis-prone mouse models. In a clinical study of healthy, pre-diabetes, diabetes, and diabetic patients with CVD (DM-CVD) subjects (n = 10-11 per group), DM-CVD neutrophils exhibited a distinct impedance signature and pro-inflammatory transcriptomic profile marked by cytoskeletal dysregulation and altered RhoA signaling. Principal component analysis (area under the curve= 0.971) identifies individuals with vascular dysfunction exhibiting increased carotid intima-media thickness and reduced reactive hyperemia index. These findings support impedance-based neutrophil profiling as a promising, cost-effective strategy for cardiovascular risk stratification in T2DM.

Background: Diabetic neuropathy affects almost half of diabetic patients, yet the relative contributions of metabolic, vascular and clinical factors remain controversial. We aimed to investigate which risk factors are more associated with reduced corneal nerve fiber length (CNFL). Methods: This is a cross-sectional study of 30 patients with type 2 diabetes. We assessed metabolic parameters (HbA1c, lipids), vascular measurements (Doppler ultrasonography of carotid and ophthalmic arteries, central vessel density measured by optical coherence tomography angiography), and corneal epithelial thickness. We explored the data using network analysis, then applied penalized mixed-effect regression (in which β represents the standardized coefficients with mean 0 and unit standard deviation), followed by generalized additive models and polynomial transformations. Results: Penalized regression identified vascular parameters as dominant predictors: carotid plaques (β = −0.609) and intima-media thickness (β = −0.574) showed the strongest associations with CNFL. Traditional metabolic markers including HbA1c failed to meet selection thresholds. Bifurcation velocity (β = −0.313) and corneal sensitivity measures (β = 0.278–0.135) were also significant. The non-linear modeling showed complex vascular–structural interactions. Conclusions: Vascular compromise, particularly carotid disease, had the highest association with CNFL in our cohort. Thus, our study reports a higher effect of vascular parameters than HbA1c in patients with a longer history of diabetes. This may reflect the progression of diabetic complications, where initial metabolic insults are followed by vascular pathology as the primary driver of end-organ damage. Our findings highlight the need for carotid artery screening in diabetic patients for a better estimation of the neuropathy risk.

BackgroundStenoses of the outflow tract can compromise the function of arteriovenous fistulas (AVFs) used for haemodialysis. Limited data exists to differentiate stenosis types and understand their underlying causes. This study aims to develop a new classification system for AVF stenoses based on the morphology and location of the lesions as assessed by duplex ultrasound (DUS).Materials and methodsA multicenter, cross-sectional cohort study was conducted in four hospitals from October 2017 to February 2024. After exclusions, 1122 patients with dysfunctional AVFs were evaluated. The DUS variables studied were intimal-media thickness (IMT), venous valve calcifications (VVC), and stenosis location. The stenosis location was classified as follows: juxta/post anastomotic tract; middle tract; proximal tract; arm cephalic vein tract; cephalic arch; and arm basilic vein tract.ResultsIntimal hyperplasia (corresponding to IMT ≥ 0.4 mm) was present in 718 AVFs (64%; 95% CI 0.61–0.67), with an average thickness of 0.72 ± 0.14 mm (95% CI 0.71–0.73); no intimal hyperplasia (corresponding to IMT < ≥≥0.4 mm) in 354 AVFs (32%; 95% CI 0.29–0.34), and valve calcification in 50 AVFs (4%; 95% CI 3–6). Stenoses were classified in 4 types: Type A, dominant IMT with thickness ≥ 0.6 mm; Type B, IMT 0.4 mm to 0.6 mm; Type C, IMT < 0.4 mm; and Type D, with calcifications of the venous valves. Most of the stenosis fell within Type A and C (79.5%). Type A stenosis was in 80% found in the juxta/post-anastomotic segments. The middle and proximal tract segments showed a similar distribution of all four types of stenosis. Type C and D stenosis were prevalent in the distal segments.ConclusionDUS reveals distinct characteristics of AVF stenoses, suggesting different underlying causes. This classification system may facilitate the development of targeted interventions for preventing and treating AVF stenosis.Clinical trial numberNot applicable.

Aim of study. To analyze the state of the left ventricular geometry and structural features of the common carotid artery in men and women with chronic noncommunicable diseases. Material and methods. Clinical and instrumental data of 475 patients with chronic non-communicable diseases were used. The average age of the participants was 52.3±13.4 years, all patients underwent general clinical examination. The frequency of various structural changes in the left ventricular (LV) myocardium and the intima-media thickness of the common carotid artery (CCA) were analyzed. Patients were divided into subgroups of men (n=237) and women (n=238). Results. In the examined men, the levels of creatinine, cystatin C, and the LV myocardial mass index were significantly higher, while the glomerular filtration rate was significantly lower. In the subgroup of women, hemoglobin concentration and the number of erythrocytes were significantly lower, whereas the number of platelets was significantly higher. In individuals with chronic non-communicable diseases, structural LV changes were represented as follows: normal geometry (68.0%), concentric remodeling (6.1%), LV hypertrophy (25.8%), including concentric LVH (41.5%) and eccentric LVH (58.5%). Concentric remodeling was observed in 8.0% of men and 4.2% of women. The frequency of LVH was significantly higher in women (31.0%) compared to men (20.6%). Initial atherosclerotic changes were detected in 23.8% of patients, while atherosclerotic lesions of the CCA were found in 33.3%. In men, the frequency of CCA atherosclerotic lesions was significantly higher (41.3%) than in women (25.2%). In the subgroup of women with atherosclerotic lesions of the CCA, the incidence of LVH was significantly higher than in women without CCA lesions. Cystatin C positively correlated with the LV myocardial mass index (r=0.41143; p&lt;0.005), relative LV wall thickness (r=0.27340; p&lt;0.05), and CCA intima-media thickness (r=0.3027; p&lt;0.05). Conclusion. Left ventricular hypertrophy, especially the eccentric type, is frequently detected in patients with chronic non-communicable diseases, predominantly in women. Structural changes of the CCA are significantly more often detected in men. As the intima-media thickness of the CCA increases, the incidence of LVH also increases. Cystatin C concentration is associated with structural changes in the LV myocardium and CCA.

Hypertension is the most prevalent RF for cerebrovascular disease (CVD). Although previous studies have employed ultrasonography and phase-contrast magnetic resonance image (MRI) to assess cerebral hemodynamics, the quantitative impact of hypertension on cerebral arterial flow characteristics remains incompletely understood. This study focused on the relationship between hypertension, other risk factors (RF), and arterial velocity gradient using the signal intensity gradient (SIG) from time-of-flight magnetic resonance angiography (TOF-MRA). This cross-sectional study included individuals who underwent health screening at our institution between January 2015 and June 2021. Participants with no history of CVD who underwent intracranial TOF-MRA were included. Arterial wall SIGs was measured in the cerebral arteries. Participants were categorized into four groups according to vascular RFs: none (no RF), other RFs (RFs except hypertension), hypertension-only, and hypertension-plus (hypertension with other RFs). Atotal of 1154 healthy subjects (mean age 63.2 ± 9.5years, 43.2% women) were enrolled. The hypertension-plus group had the highest systolic (125.3 ± 19.1 mm Hg) and diastolic (74.7 ± 10.5 mm Hg) blood pressures, HbA1c (6.1 ± 0.7%), intima-media thickness (0.86 ± 0.24 mm), and the highest rates of intracranial artery stenosis (14.4%) and chronic kidney disease (6.1%). The hypertension-plus group showed the lowest SIG values among all cerebral arteries. After adjusting for confounding factors, the hypertension-plus group showed significantly lower SIG values in the intracranial arteries but not in the extracranial arteries. The arterial wall SIG was significantly associated with hypertension and other vascular RFs. SIG may offer quantitative information on the arteriopathic effects of hypertension, especially intracranial cerebral arteries.

The aim of this study is to examine the association between the cardiometabolic index (CMI) and carotid intima-media thickness (cIMT) in patients with lacunar stroke (LS). A retrospective analysis was conducted on 155 patients with LS who underwent carotid ultrasonography at Zhongshan Hospital affiliated with Xiamen University between March 2022 and May 2024. Based on cIMT measurements, participants were categorized into 3 groups: normal (n=54), thickening (n=57), and plaque (n=44). Clinical data were collected, CMI was calculated, intergroup comparisons were performed, and the correlation between CMI and the severity of carotid lesions was evaluated. A total of 155 patients with LS, comprising 72 males and 83 females, with a mean age of 65.83±12.34 years, were included in this study. CMI levels were significantly elevated in the cIMT thickening and plaque groups compared with the normal group. Multiple logistic regression analysis demonstrated a significant positive association between CMI and cIMT progression (β=0.13, 95% CI: 0.08-0.17, P<0.001), and this association remained significant after adjustment for covariates, including age, sex, body mass index, smoking, alcohol consumption, hypertension, diabetes, and ischemic heart disease. Quartile analysis of CMI indicated that patients in the highest quartile of CMI exhibited a significantly increased risk of cIMT progression (β=0.27, 95% CI: 0.05-0.49, P=0.02). Receiver operating characteristic analysis demonstrated that CMI was an effective predictor of cIMT progression (area under the curve=0.706, 95% CI: 0.61-0.80). The independent association between CMI and cIMT progression indicates that CMI may serve as a potential indicator for assessing the risk of carotid lesions in patients with LS, providing a basis for early screening and intervention.

Background. Here we present a diagnostically challenging case of ANCA-associated vasculitis (AAV) that initially presented with clinical features highly suggestive of giant cell arteritis (GCA). Case Report. An 80-year-old woman, with a medical history notable only for prior COVID-19 pneumonitis and a diagnosis of polymyalgia rheumatica (PMR) in 2024, presented to the emergency department in February 2025 with a three-week history of worsening pelvic and scapular girdle pain. Routine laboratory tests revealed elevated inflammatory markers (ESR 76 mm/h, CRP 16.8 mg/dL) and findings consistent with a urinary tract infection (UTI), with preserved renal function (GFR &gt;60 mL/min). A presumptive diagnosis of a PMR flare triggered by the UTI was made, and antibiotic therapy was initiated. Due to the persistence of symptoms, she was referred to the rheumatology unit. A positive history of recent unintentional weight loss and new-onset jaw claudication emerged. Given the high clinical suspicion of giant cell arteritis (GCA), corticosteroid therapy was promptly initiated. Subsequent vascular ultrasound revealed intima-media complex thickening and a positive compression sign in the left frontal artery, along with moderate intima-media thickening of the right facial artery. While suggestive of GCA, these findings were insufficient for a definitive diagnosis. Following an initial symptom remission, corticosteroid tapering led to a relapse of jaw claudication and the new onset of widespread livedo reticularis. Additionally, previously absent signs of acute kidney injury (AKI) emerged, prompting hospital admission for further diagnostic workup. Laboratory testing revealed persistently elevated ESR and CRP levels, significant renal impairment (creatinine 1.67 mg/dL, GFR 29 mL/min), and positive anti-MPO antibodies (37.0 UI/mL). Over the following days, renal function deteriorated rapidly (creatinine rising to 2.2 mg/dL). Given the progressive AKI and ANCA-MPO positivity, a diagnosis of ANCA-associated vasculitis (AAV) with glomerulonephritis was established. Treatment included three intravenous methylprednisolone pulses followed by two 1 g rituximab infusions administered two weeks apart. A PET-CT scan performed shortly after steroid initiation showed no evidence of large vessel involvement. Furthermore, chest X-ray and electromyography revealed no abnormalities suggestive of other organ manifestations of AAV. At one-month follow-up, renal function had sligthly improved (creatinine 1.5 mg/dL, GFR 33 mL/min), while inflammatory markers and anti-MPO titers (5 UI/mL) had significantly decreased. The coexistence or sequential development of GCA and AAV, though rare, has been documented [Tab 1]. In our case, the absence of a temporal artery biopsy prevents the definitive exclusion of GCA and raises the possibility of an overlap syndrome, rather than an atypical manifestation of AAV mimicking cranial vasculitis. Conclusions. This case highlights the importance of considering alternative diagnoses in patients with atypical GCA presentations, particularly when temporal artery biopsy is unavailable.

This study examines the association between metabolic-dysfunction-associated steatotic liver disease (MASLD) and cardiovascular risk, focusing on the predictive value of anthropometric, metabolic, and hepatic markers. A predictive cross-sectional study was conducted in children aged 5-18 years with overweight, obesity, or metabolic alterations suggestive of hepatic steatosis, with and without MASLD, at a Mexican pediatric endocrine clinic. MASLD was diagnosed via ultrasound, while cardiovascular risk was assessed using carotid intima-media thickness (CIMT) and metabolic markers. Multiple regression models were developed to evaluate the contribution of vascular (CIMT), anthropometric, metabolic, and hepatic variables to cardiovascular risk. Children with MASLD had significantly higher body mass index (BMI) percentiles (97.56 ± 2.93 vs. 68.91 ± 33.89, p < 0.01), systolic blood pressure (SBP): 113.93 ± 9.38 mmHg versus 101.41 ± 11.45 mmHg, p < 0.01), and Homeostasis Model Assessment of Insulin Resistance (HOMA-IR): 7.55 ± 2.23 versus 3.62 ± 1.76, p < 0.01) compared to controls. CIMT was greater in MASLD patients (0.738 mm vs. 0.56 mm, p < 0.01), suggesting early vascular remodeling. Model 4, which incorporated CIMT, metabolic markers, and liver enzymes, demonstrated the highest predictive value (R² = 0.935, p < 0.001), reinforcing the multifactorial nature of MASLD-related cardiovascular risk. MASLD is strongly associated with subclinical atherosclerosis and cardiometabolic dysregulation in children. The progressive increase in predictive accuracy across models underscores the importance of a multifactorial approach to cardiovascular risk assessment. Early subclinical cardiovascular findings are detectable in children with MASLD, supporting the rationale for early risk stratification and further research in this population.

To observe the clinical effect and safety of herbal cake-insulated moxibustion in the auxiliary treatment of carotid atherosclerosis (CAS) differentiated as interaction of phlegm and blood stasis. Sixty-three patients with CAS differentiated as interaction of phlegm and blood stasis were randomly divided into an experimental group (33 cases, 4 cases dropped out) and a control group (30 cases, 3 cases dropped out). In the experimental group, herbal cake-insulated moxibustion was delivered in combination with oral administration with atorvastatin. In the control group, atorvastatin was administered orally. The duration of treatment in either group was composed of 12 weeks. Common carotid intima-media thickness (cIMT), the total area of carotid plaque, common carotid blood flow parameters, blood lipids contents (4 items) and traditional Chinese medicine (TCM) syndrome score were compared between the two groups before and after treatment. Blood routine and liver and kidney function were detected before and after treatment, and adverse events were recorded to evaluate safety. Compared with those before treatment, the bilateral cIMT and the contents of total cholesterol (TC), triglyceride (TG) and low-density lipoprotein cholesterol (LDL-C) in serum were reduced after treatment (P<0.05, P<0.001), the scores of the primary symptoms and secondary symptoms of TCM, as well as the total score were lower (P<0.001) in the two groups. The left cIMT and the contents of the serum TC, TG and LDL-C in the experimental group were lower than those of the control group (P<0.05, P<0.01), and the scores of the primary symptoms and secondary symptoms of TCM, as well as the total score were lower than those of the control group (P<0.001, P<0.01). After treatment, the bilateral peak systolic velocity (PSV) and end diastolic velocity (EDV) were increased in the experimental group (P<0.001), the right EDV was increased in the control group (P<0.001), and the bilateral PSV and EDV in the experimental group were higher than those of the control group (P<0.05, P<0.01, P<0.001). After treatment, there was no significant difference in the total area of carotid plaque between the two groups. After treatment, there were no significant abnormalities in blood routine and liver and kidney functions in both groups, and the safety was good. On the basis of conventional medication, the herbal cake-insulated moxibustion as an auxiliary treatment, presents its synergistic effect on CAS of interaction of phlegm and blood stasis syndrome in the patients, and this therapy is safe in clinical application.

Introduction: Chronic kidney disease (CKD) is associated with a high risk of cardiovascular complications and mortality. This study aimed to assess the relationship between the diurnal blood pressure (BP) profile, progression of CKD, and hypertension-mediated organ damage (HMOD) in patients with CKD stages 1–3 during a 6-month observation period. Methods: Eighty-seven patients with CKD stages 1–3 underwent 24 h ambulatory blood pressure monitoring (ABPM), echocardiography, carotid intima-media thickness (IMT) assessment, and aortic pulse wave velocity (PWV) measurement at baseline and after 6 months. Serum creatinine and the estimated glomerular filtration rate (eGFR) were evaluated using the CKD-EPI formula. Results: Based on ABPM, patients were classified as dippers/extreme dippers (D/ED, 35.6%), non-dippers (ND, 47.2%), and reverse dippers (RD, 17.2%). At follow-up, the RD group showed a significant decline in the eGFR and a lower left ventricular ejection fraction compared to D/ED. IMT values were consistently higher in RD than in D/ED at baseline and follow-up. No significant differences in PWV were observed. Conclusions: An abnormal diurnal BP profile is common in patients with CKD stages 1–3. The “reverse dipper” profile is associated with faster CKD progression, more advanced vascular remodeling, and reduced left ventricular function. The results of our study support the role of ABPM as a useful tool in assessing risk in the early stages of CKD, providing additional prognostic information beyond office blood pressure measurements. Limitations: The relatively small sample size, short follow-up period, lack of detailed data on treatment modifications, and absence of orthostatic BP assessment may limit the interpretation and generalizability of the results.

PurposeTo determine the independent association of carotid intima-media thickness (CIMT) and periventricular white matter hyperintensities (PWMHs) with mild cognitive impairment in Parkinson’s disease (PD-MCI) and evaluate the diagnostic value of CIMT combined with PWMHs for PD-MCI.Patients and MethodsA prospective cohort of 541 PD patients was enrolled, and all patients underwent carotid artery ultrasound for mean CIMT measurement and 3T brain MRI for PWMH volume quantification. PD-MCI was diagnosed via comprehensive neuropsychological assessment (10 tests across 5 domains) based on established criteria, ie, at least two tests demonstrated abnormal results, either one impaired test in two different cognitive domains or two impaired tests in a single cognitive domain. Multivariate analysis was conducted to determine the independent association, and the receiver operating characteristic (ROC) curve was employed to assess the diagnostic values, and the Z test was employed to compare the area under curve (AUC).ResultsPD-MCI prevalence was 45.5% (246/541). Multivariate analysis, adjusting for education duration, Cys C levels, disease duration, total brain WMHs, hypertension, hyperlipidemia, and age, identified PWMHs [odds ratio (OR): 2.114, 95% confidence interval (CI): 1.391–4.586], CIMT (OR: 2.027, 95% CI: 1.485–4.281), homocysteine (OR: 1.551, 95% CI: 1.172–2.680), Hoehn and Yahr stage (OR: 2.243, 95% CI: 1.534–4.736), and MDS-UPDRS part III score (OR: 1.416, 95% CI: 1.158–2.465) as independent PD-MCI predictors. ROC analysis demonstrated significantly higher diagnostic value for the combination of CIMT and PWMHs (AUC: 0.908, 95% CI: 0.882–0.934) compared to either marker alone (AUC: 0.705, 95% CI: 0.661–0.750 for PWMHs; AUC: 0.722, 95% CI: 0.678–0.765 for CIMT; both P < 0.001).ConclusionThe combination of CIMT and PWMHs provides significantly superior diagnostic value for PD-MCI compared to either marker individually, and this integrated model suggests a potential tool for identifying PD patients at high risk for cognitive decline.