P25: Vascular Aging is associated with The Severity of Cerebral White Matter Lesion Load

Abstract

Background

Blood pressure (BP) levels and aortic stiffness are associated with the presence of cerebal small vessel disease, whereas little is known on the possible association of BP levels, aortic stiffness and the severity of cerebral small vessel disease. In a pilot study we investigated whether he-modynamic measures are associated with the presence and severity of cerebral white matter lesion load (WML).

Methods

Fazekas score was used to analyse WML on neuroimaging of 84 persons visiting the Outpatient Geriatric Clinic; an automatic white matter hyperintensity segmentation method was used in a subgroup of 44 MRI-scans to determine the exact volume of WML. Aortic stiffness, measured as aortic pulse wave velocity (aPWV), and BP levels were non-invasively measured by Mobil-o-Graph.

Results

Mean age was 76.6 years. Age was correlated with aPWV (r² = 0.722, p < 0.001) and volume of WML (r² = 0.296, p < 0.001). aPWV and central pulse pressure levels (cPP) increased with increasing Fazekas score (p for trend <0.001 and 0.043, respectively). After adjustment, higher aPWV was observed in the highest Fazekas category compared to the lowest, although not statically significant (p for trend = 0.151). Both cPP and aPWV were associated with WML volumes in univariate analyses (lnβ 0.298, p = 0.055 and lnβ 0.541, p <0.001, respectively); in multivariate analyses, estimates were less consistent.

Conclusion

Increased pulse pressure and increased aortic stiffness were associated with the severity of WML, assessed with both Fazekas score and a quantative hyperintenstity segmentation method. Age is highly associated with aortic stiffness and cerebral small vessel disease.