Cerebral Microbleeds as Predictors of Mortality: The Framingham Heart Study

José R. Romero, Sarah R. Preis, Alexa Beiser, Jayandra J. Himali, Ashkan Shoamanesh, Philip A. Wolf, Carlos S. Kase, Ramachandran S. Vasan, Charles DeCarli, Sudha Seshadri

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Background and Purpose - Cerebral microbleeds (CMB) represent a common magnetic resonance imaging marker of cerebral small vessel disease, increasingly recognized as a subclinical marker of stroke and dementia risk. CMB detection may reflect the cumulative effect of vascular risk burden and be a marker of higher mortality. We investigated the relation of CMB to risk of death in community dwelling participants free of stroke and dementia. Methods - We evaluated 1963 Framingham Original and Offspring Cohort participants (mean age 67 years; 54% women) with available brain magnetic resonance imaging and mortality data. Using Cox proportional hazards models, we related CMB to all-cause, cardiovascular, and stroke-related mortality. Results - Participants with CMB (8.9%) had higher prevalence of cardiovascular risk factors and use of preventive medications. During a mean follow-up of 7.2±2.6 years, we observed 296 deaths. In age- and sex-adjusted analysis, CMB were associated with increased all-cause mortality (hazards ratio, 1.39; 95% confidence interval 1.03-1.88), a relation that was no longer significant after adjustment for cardiovascular risk and preventive medication use (hazards ratio, 1.15; 95% confidence interval, 0.82-1.63). Conclusions - CMBs may represent the deleterious effect of cardiovascular risk factors in the cerebral vasculature. Although their presence was associated with increased all-cause mortality, the effect was no longer present after accounting for vascular risk factors and preventive treatment use. Further studies are required to clarify the role of cardiovascular preventive therapies for prevention of mortality in persons with incidental detection of CMB.

Original languageEnglish (US)
Pages (from-to)781-783
Number of pages3
JournalStroke
Volume48
Issue number3
DOIs
StatePublished - Mar 1 2017

Fingerprint

Mortality
Dementia
Cerebral Small Vessel Diseases
Stroke
Magnetic Resonance Imaging
Confidence Intervals
Independent Living
Risk Adjustment
Proportional Hazards Models
Blood Vessels
Myocardial Infarction
Brain
Therapeutics

Keywords

  • cerebral microbleed
  • cerebral small vessel disease
  • community
  • epidemiology

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing

Cite this

Romero, J. R., Preis, S. R., Beiser, A., Himali, J. J., Shoamanesh, A., Wolf, P. A., ... Seshadri, S. (2017). Cerebral Microbleeds as Predictors of Mortality: The Framingham Heart Study. Stroke, 48(3), 781-783. https://doi.org/10.1161/STROKEAHA.116.015354

Cerebral Microbleeds as Predictors of Mortality : The Framingham Heart Study. / Romero, José R.; Preis, Sarah R.; Beiser, Alexa; Himali, Jayandra J.; Shoamanesh, Ashkan; Wolf, Philip A.; Kase, Carlos S.; Vasan, Ramachandran S.; DeCarli, Charles; Seshadri, Sudha.

In: Stroke, Vol. 48, No. 3, 01.03.2017, p. 781-783.

Research output: Contribution to journalArticle

Romero, JR, Preis, SR, Beiser, A, Himali, JJ, Shoamanesh, A, Wolf, PA, Kase, CS, Vasan, RS, DeCarli, C & Seshadri, S 2017, 'Cerebral Microbleeds as Predictors of Mortality: The Framingham Heart Study', Stroke, vol. 48, no. 3, pp. 781-783. https://doi.org/10.1161/STROKEAHA.116.015354
Romero JR, Preis SR, Beiser A, Himali JJ, Shoamanesh A, Wolf PA et al. Cerebral Microbleeds as Predictors of Mortality: The Framingham Heart Study. Stroke. 2017 Mar 1;48(3):781-783. https://doi.org/10.1161/STROKEAHA.116.015354
Romero, José R. ; Preis, Sarah R. ; Beiser, Alexa ; Himali, Jayandra J. ; Shoamanesh, Ashkan ; Wolf, Philip A. ; Kase, Carlos S. ; Vasan, Ramachandran S. ; DeCarli, Charles ; Seshadri, Sudha. / Cerebral Microbleeds as Predictors of Mortality : The Framingham Heart Study. In: Stroke. 2017 ; Vol. 48, No. 3. pp. 781-783.
@article{e9a3f3f68522419a89ebee9dc29155b5,
title = "Cerebral Microbleeds as Predictors of Mortality: The Framingham Heart Study",
abstract = "Background and Purpose - Cerebral microbleeds (CMB) represent a common magnetic resonance imaging marker of cerebral small vessel disease, increasingly recognized as a subclinical marker of stroke and dementia risk. CMB detection may reflect the cumulative effect of vascular risk burden and be a marker of higher mortality. We investigated the relation of CMB to risk of death in community dwelling participants free of stroke and dementia. Methods - We evaluated 1963 Framingham Original and Offspring Cohort participants (mean age 67 years; 54{\%} women) with available brain magnetic resonance imaging and mortality data. Using Cox proportional hazards models, we related CMB to all-cause, cardiovascular, and stroke-related mortality. Results - Participants with CMB (8.9{\%}) had higher prevalence of cardiovascular risk factors and use of preventive medications. During a mean follow-up of 7.2±2.6 years, we observed 296 deaths. In age- and sex-adjusted analysis, CMB were associated with increased all-cause mortality (hazards ratio, 1.39; 95{\%} confidence interval 1.03-1.88), a relation that was no longer significant after adjustment for cardiovascular risk and preventive medication use (hazards ratio, 1.15; 95{\%} confidence interval, 0.82-1.63). Conclusions - CMBs may represent the deleterious effect of cardiovascular risk factors in the cerebral vasculature. Although their presence was associated with increased all-cause mortality, the effect was no longer present after accounting for vascular risk factors and preventive treatment use. Further studies are required to clarify the role of cardiovascular preventive therapies for prevention of mortality in persons with incidental detection of CMB.",
keywords = "cerebral microbleed, cerebral small vessel disease, community, epidemiology",
author = "Romero, {Jos{\'e} R.} and Preis, {Sarah R.} and Alexa Beiser and Himali, {Jayandra J.} and Ashkan Shoamanesh and Wolf, {Philip A.} and Kase, {Carlos S.} and Vasan, {Ramachandran S.} and Charles DeCarli and Sudha Seshadri",
year = "2017",
month = "3",
day = "1",
doi = "10.1161/STROKEAHA.116.015354",
language = "English (US)",
volume = "48",
pages = "781--783",
journal = "Stroke",
issn = "0039-2499",
publisher = "Lippincott Williams and Wilkins",
number = "3",

}

TY - JOUR

T1 - Cerebral Microbleeds as Predictors of Mortality

T2 - The Framingham Heart Study

AU - Romero, José R.

AU - Preis, Sarah R.

AU - Beiser, Alexa

AU - Himali, Jayandra J.

AU - Shoamanesh, Ashkan

AU - Wolf, Philip A.

AU - Kase, Carlos S.

AU - Vasan, Ramachandran S.

AU - DeCarli, Charles

AU - Seshadri, Sudha

PY - 2017/3/1

Y1 - 2017/3/1

N2 - Background and Purpose - Cerebral microbleeds (CMB) represent a common magnetic resonance imaging marker of cerebral small vessel disease, increasingly recognized as a subclinical marker of stroke and dementia risk. CMB detection may reflect the cumulative effect of vascular risk burden and be a marker of higher mortality. We investigated the relation of CMB to risk of death in community dwelling participants free of stroke and dementia. Methods - We evaluated 1963 Framingham Original and Offspring Cohort participants (mean age 67 years; 54% women) with available brain magnetic resonance imaging and mortality data. Using Cox proportional hazards models, we related CMB to all-cause, cardiovascular, and stroke-related mortality. Results - Participants with CMB (8.9%) had higher prevalence of cardiovascular risk factors and use of preventive medications. During a mean follow-up of 7.2±2.6 years, we observed 296 deaths. In age- and sex-adjusted analysis, CMB were associated with increased all-cause mortality (hazards ratio, 1.39; 95% confidence interval 1.03-1.88), a relation that was no longer significant after adjustment for cardiovascular risk and preventive medication use (hazards ratio, 1.15; 95% confidence interval, 0.82-1.63). Conclusions - CMBs may represent the deleterious effect of cardiovascular risk factors in the cerebral vasculature. Although their presence was associated with increased all-cause mortality, the effect was no longer present after accounting for vascular risk factors and preventive treatment use. Further studies are required to clarify the role of cardiovascular preventive therapies for prevention of mortality in persons with incidental detection of CMB.

AB - Background and Purpose - Cerebral microbleeds (CMB) represent a common magnetic resonance imaging marker of cerebral small vessel disease, increasingly recognized as a subclinical marker of stroke and dementia risk. CMB detection may reflect the cumulative effect of vascular risk burden and be a marker of higher mortality. We investigated the relation of CMB to risk of death in community dwelling participants free of stroke and dementia. Methods - We evaluated 1963 Framingham Original and Offspring Cohort participants (mean age 67 years; 54% women) with available brain magnetic resonance imaging and mortality data. Using Cox proportional hazards models, we related CMB to all-cause, cardiovascular, and stroke-related mortality. Results - Participants with CMB (8.9%) had higher prevalence of cardiovascular risk factors and use of preventive medications. During a mean follow-up of 7.2±2.6 years, we observed 296 deaths. In age- and sex-adjusted analysis, CMB were associated with increased all-cause mortality (hazards ratio, 1.39; 95% confidence interval 1.03-1.88), a relation that was no longer significant after adjustment for cardiovascular risk and preventive medication use (hazards ratio, 1.15; 95% confidence interval, 0.82-1.63). Conclusions - CMBs may represent the deleterious effect of cardiovascular risk factors in the cerebral vasculature. Although their presence was associated with increased all-cause mortality, the effect was no longer present after accounting for vascular risk factors and preventive treatment use. Further studies are required to clarify the role of cardiovascular preventive therapies for prevention of mortality in persons with incidental detection of CMB.

KW - cerebral microbleed

KW - cerebral small vessel disease

KW - community

KW - epidemiology

UR - http://www.scopus.com/inward/record.url?scp=85011299946&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85011299946&partnerID=8YFLogxK

U2 - 10.1161/STROKEAHA.116.015354

DO - 10.1161/STROKEAHA.116.015354

M3 - Article

C2 - 28143923

AN - SCOPUS:85011299946

VL - 48

SP - 781

EP - 783

JO - Stroke

JF - Stroke

SN - 0039-2499

IS - 3

ER -