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 language | English (US) |
|---|---|
| Pages (from-to) | 781-783 |
| Number of pages | 3 |
| Journal | Stroke |
| Volume | 48 |
| Issue number | 3 |
| DOIs | |
| State | Published - Mar 1 2017 |
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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
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 journal › Article
}
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 -