Absence of association between arterial stiffness and white matter hyperintensities in otherwise healthy hypertensive elderly Chinese

Abstract

Introduction: Arterial stiffness has been observed to be associated with white matter hyperintensities (WMH) in different populations. This study aimed to investigate whether such association exists in otherwise healthy hypertensive elderly Chinese. Methods: Degree of WMH has been assessed based on fluid-attenuated inversion recovery (FLAIR) magnetic resonance imaging using Fazekas white matter scale scores, and then dichotomised to compare with quartiles of brachial-ankle pulse wave velocity (BaPWV), a marker of arterial stiffness. Univariate and multivariate logistic regression models were used to determine the odds ratio (OR) for advanced WMH. Results: We studied a population of 252 otherwise healthy hypertensive Chinese over 65 years old, and advanced WMH was present in 53 (22.4%). In the highest BaPWV quartile, 22 (34.9%) subjects had advanced WMH. Significant association was observed between the highest quartile of BaPWV and advanced WMH when using the univariate logistic regression model. However, after controlling for demographic and arterial vascular risk factors (age, gender, body mass index, smoke history, grade of hypertension, duration of hypertension, total cholesterol, triglycerides, and high-density lipoprotein cholesterol), there was no statistically significant association (odds ratio = 2.101; 95% confidence interval, 0.781-5.649). Conclusion: This study did not provide any evidence for significant association between arterial stiffness and WMH. Fazekas white matter scale score may be too simple a tool to reveal the association and we shall pursuit more suitable resolution for further investigation.