Cerebral small vessel disease, systemic vascular characteristics and potential therapeutic targets
dc.contributor.author | Elyas, S | |
dc.contributor.author | Adingupu, D | |
dc.contributor.author | Aizawa, K | |
dc.contributor.author | Casanova, F | |
dc.contributor.author | Gooding, K | |
dc.contributor.author | Fulford, J | |
dc.contributor.author | Mawson, D | |
dc.contributor.author | Gates, PE | |
dc.contributor.author | Shore, AC | |
dc.contributor.author | Strain, D | |
dc.date.accessioned | 2021-09-29T14:09:24Z | |
dc.date.issued | 2021-09-22 | |
dc.description.abstract | Introduction: Cerebral small vessel disease (SVD) is prevalent in the elderly population and is associated with increased risk of dementia, stroke and disability. Currently there are no clear targets or strategies for the treatment of cerebral SVD. We set out to identify modifiable vascular treatment targets. Patients and Methods: 112 participants with and without a history of CVD underwent macrovascular, microvascular and endothelial function tests and an MRI head scan. Results: Increased carotid intima media thickness and carotid-femoral pulse wave velocity were associated with cerebral WMH (β=1·1 p=0·001 and β=1·66, p<0·0001 respectively). Adjusted cerebral resistance index (p=0·03) and brachial flow mediated dilation time to peak (p=0·001) were associated with the severity of cerebral WMH independent of age and sex. Post occlusive reactive hyperaemia time as a measure of microvascular reactivity was associated with WMH after adjustment for age and sex (p=0·03). Ankle Brachial Pressure Index and urinary albumin excretion rate predicted the severity of cerebral WMH (p=0·02 and 0·01 respectively). Age and hypertension were the most important risk factors for WMH severity (p< 0·0001). Discussion: In addition to hypertension, microalbuminuria, arterial stiffness, vascular reactivity and cerebrovascular resistance could be potential treatment targets to halt the development or progression of cerebral SVD. | en_GB |
dc.description.sponsorship | National Institute for Health Research | en_GB |
dc.identifier.citation | Published online 22 September 2021 | en_GB |
dc.identifier.doi | 10.18632/aging.203557 | |
dc.identifier.uri | http://hdl.handle.net/10871/127278 | |
dc.language.iso | en | en_GB |
dc.publisher | Impact Journals | en_GB |
dc.rights | Copyright: © 2021 Elyas et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. | en_GB |
dc.subject | cerebral small vessel disease | en_GB |
dc.subject | white matter hyperintensities | en_GB |
dc.subject | leucoaraiosis | en_GB |
dc.subject | vascular markers | en_GB |
dc.subject | dementia | en_GB |
dc.title | Cerebral small vessel disease, systemic vascular characteristics and potential therapeutic targets | en_GB |
dc.type | Article | en_GB |
dc.date.available | 2021-09-29T14:09:24Z | |
dc.identifier.issn | 1945-4589 | |
dc.description | This is the final version. Available from Impact Journals via the DOI in this record. | en_GB |
dc.description | The research data supporting this publication are openly available from the University of Exeter's institutional repository. | en_GB |
dc.identifier.journal | Aging | en_GB |
dc.rights.uri | https://creativecommons.org/licenses/by/3.0/ | en_GB |
dcterms.dateAccepted | 2021-08-01 | |
exeter.funder | ::University of Colorado | en_GB |
rioxxterms.version | VoR | en_GB |
rioxxterms.licenseref.startdate | 2021-09-22 | |
rioxxterms.type | Journal Article/Review | en_GB |
refterms.dateFCD | 2021-09-29T14:06:17Z | |
refterms.versionFCD | VoR | |
refterms.dateFOA | 2021-09-29T14:09:37Z | |
refterms.panel | A | en_GB |
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Except where otherwise noted, this item's licence is described as Copyright: © 2021 Elyas et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.