New Study Published on Cross-Sectional and Longitudinal Associations Between Cardiovascular Risk Factors and White Matter Lesions

A paper investigating the association between cardiovascular risk factors (hypertension, diabetes, dyslipidemia, and current smoking) and white matter lesions (WML) has been published in the Journal of Atherosclerosis and Thrombosis.

WML is known to be associated with the future onset of dementia and cerebrovascular disease. While cardiovascular risk factors are believed to contribute to WML progression, the association between changes in WML volume and these risk factors across a wide age spectrum, particularly including younger populations, has remained unclear.

In this study, the research team analyzed 4,595 participants aged 21 to 90 who took part in the baseline assessment of the Tohoku Medical Megabank Project Community-Based Cohort Study (the first health survey conducted between 2013 and 2016) and underwent brain MRI scans as part of the Brain and Mental Health Survey (first and second rounds). During a median follow-up period of 4.3 years, the associations between the presence of each cardiovascular risk factor and WML volume were examined both cross-sectionally and longitudinally across different age groups (under 50, 50s, 60s, and 70 and older). The study also evaluated the relationship between the number of cardiovascular risk factors present and WML volume.

The results showed that in the cross-sectional analysis, hypertension in particular demonstrated a significant association with larger WML volume across all age groups. In contrast, the longitudinal analysis revealed that hypertension, diabetes, and dyslipidemia were significantly associated with an increase in WML volume in individuals under 50 years of age, whereas current smoking showed a significant increase in WML volume in those in their 50s and older. Furthermore, individuals with a higher number of cardiovascular risk factors exhibited larger WML volumes, with a greater tendency for WML volume increase observed particularly in those under 50 and in their 50s.

This study suggests that cardiovascular risk factors may contribute to WML progression, especially in younger age groups. Additionally, because the associated factors and age groups differed between the cross-sectional and longitudinal analyses, the findings highlight the importance of evaluating temporal changes to fully understand WML. Appropriate management of cardiovascular risk factors from a young age is expected to contribute to the prevention of future dementia and cerebrovascular disease.

Professor Kengo Kinoshita, Deputy Executive Director of INGEM, participated in this research project.