Relationship of arterial stiffness and baseline vascular burden with new lacunes and microbleeds: A longitudinal cohort study

I bet your doctor doesn't have a protocol for testing your arterial stiffness and certainly not one for  reducing it. 

So if you have arterial stiffness what the fuck is your doctor's protocol to address the problem? Maybe something in one of these?

• stiff arteries (11 posts to May 2013)

• Arterial stiffness (26 posts to April 2016)

  • Aortic stiffness (3 posts to January 2016)

   

   

Or does your doctor incompetently not even know about testing for and correcting this problem?

 

Relationship of arterial stiffness and baseline vascular burden with new lacunes and microbleeds: A longitudinal cohort study

Luis Mena, Juan José Mengual, […], and Manuel Gómez-Choco https://orcid.org/0000-0002-4191-7574 mgomezch@csi.cat+10View all authors and affiliations

OnlineFirst

https://doi.org/10.1177/23969873231207764

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• • Abstract
  • Introduction
  • Material and methods
  • Results
  • Discussion
  • Acknowledgments
  • Ethical approval
  • Informed consent
  • Declaration of conflicting interests
  • Funding
  • ORCID iDs
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  • Data availability statement
  • References
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Abstract

Introduction:

Arterial stiffness may have a significant impact on the development of cerebral small vessel disease (cSVD).

Patients and methods:

We obtained pulse wave velocity (24-h PWV) by means of ambulatory blood pressure monitoring (ABPM) in patients with a recent small subcortical infarct (RSSI). Patients with known cardiac or arterial embolic sources were excluded. Lacunes, microbleeds, white matter hyperintensities and enlarged perivascular spaces at baseline were assessed in a brain MRI and included in a cSVD score. A follow-up MRI was obtained 2 years later and assessed for the appearance of new lacunes or microbleeds. We constructed both unadjusted and adjusted models, and subsequently selected the optimal models based on the area under the curve (AUC) of the predicted probabilities.

Results:

Ninety-two patients (mean age 67.04 years, 69.6% men) were evaluated and 25 had new lacunes or microbleeds during follow-up. There was a strong correlation between 24-h PWV and age (r = 0.942, p < 0.001). cSVD was associated with new lacunes or microbleeds when adjusted by age, 24-h PWV, NT-proBNP and hypercholesterolemia (OR 2.453, CI95% 1.381–4.358). The models exhibiting the highest discrimination, as indicated by their area under the curve (AUC) values, were as follows: 1 (AUC 0.854) – Age, cSVD score, 24-h PWV, Hypercholesterolemia; 2 (AUC 0.852) – cSVD score, 24-h PWV, Hypercholesterolemia; and 3 (AUC 0.843) – Age, cSVD score, Hypercholesterolemia.

Conclusions:

cSVD score is a stronger predictor for cSVD progression than age or hemodynamic parameters in patients with a RSSI.