Dean Shibata1, Astrid Suchy-Dicey2, Cara L Carty2,3, Tara Madhyastha4,5, Tauqeer Ali6, Lyle Best7, Thomas J Grabowski5,8, W T Longstreth8,9, Dedra Buchwald2,3. 1. Department of Radiology, University of Washington, Seattle, Washington, USA, shibatad@uw.edu. 2. Partnerships for Native Health, Washington State University, Seattle, Washington, USA. 3. Elson S Floyd College of Medicine, Washington State University, Seattle, Washington, USA. 4. Department of Radiology, University of Washington, Seattle, Washington, USA. 5. Integrated Brain Imaging Center, University of Washington, Seattle, Washington, USA. 6. Center for American Indian Health Research, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma, Oklahoma, USA. 7. Strong Heart Study-Dakota Center, Eagle Butte, South Dakota, USA. 8. Department of Neurology, University of Washington, Seattle, Washington, USA. 9. Department of Epidemiology, University of Washington, Seattle, Washington, USA.
Abstract
BACKGROUND: Clinical stroke is prevalent in American Indians, but the risk factors for cerebrovascular pathology have not been well-studied in this population. The purpose of this study was to correlate abnormalities on brain magnetic resonance imaging (MRI) with clinical risk factors in a cohort of elderly American Indians. METHODS: Brain MRI scans from 789 participants of the Strong Heart Study were analyzed for infarcts, hemorrhage, white matter disease, and measures of cerebral atrophy including ventricular and sulcal grade and total brain volume. Clinical risk factors included measures of hypertension, diabetes, and high levels of low-density lipoprotein (LDL) cholesterol. Regression models adjusted for potential confounders were used to estimate associations between risk factors and brain MRI outcomes. RESULTS: -Hypertension was associated with the presence of infarcts (p = 0.001), ventricle enlargement (p = 0.01), and increased white matter hyperintensity volume (p = 0.01). Diabetes was associated with increased prevalence of cerebral atrophy (p < 0.001), ventricular enlargement (p = 0.001), and sulcal widening (p = 0.001). High LDL was not significantly associated with any of the measured cranial imaging outcomes. CONCLUSIONS: This study found risk factors for cerebrovascular disease in American Indians similar to those seen in other populations and provides additional evidence for the important roles of hypertension and diabetes in promoting cerebral infarcts and brain atrophy, respectively.
BACKGROUND: Clinical stroke is prevalent in American Indians, but the risk factors for cerebrovascular pathology have not been well-studied in this population. The purpose of this study was to correlate abnormalities on brain magnetic resonance imaging (MRI) with clinical risk factors in a cohort of elderly American Indians. METHODS: Brain MRI scans from 789 participants of the Strong Heart Study were analyzed for infarcts, hemorrhage, white matter disease, and measures of cerebral atrophy including ventricular and sulcal grade and total brain volume. Clinical risk factors included measures of hypertension, diabetes, and high levels of low-density lipoprotein (LDL) cholesterol. Regression models adjusted for potential confounders were used to estimate associations between risk factors and brain MRI outcomes. RESULTS: -Hypertension was associated with the presence of infarcts (p = 0.001), ventricle enlargement (p = 0.01), and increased white matter hyperintensity volume (p = 0.01). Diabetes was associated with increased prevalence of cerebral atrophy (p < 0.001), ventricular enlargement (p = 0.001), and sulcal widening (p = 0.001). High LDL was not significantly associated with any of the measured cranial imaging outcomes. CONCLUSIONS: This study found risk factors for cerebrovascular disease in American Indians similar to those seen in other populations and provides additional evidence for the important roles of hypertension and diabetes in promoting cerebral infarcts and brain atrophy, respectively.
Authors: Dean Shibata; Astrid Suchy-Dicey; Cara L Carty; Tara Madhyastha; Tauqeer Ali; Lyle Best; Thomas J Grabowski; W T Longstreth; Dedra Buchwald Journal: Neuroepidemiology Date: 2019-06-04 Impact factor: 3.282