Cerebral Microbleeds, Vascular Risk Factors, and Magnetic Resonance Imaging Markers: The Northern Manhattan Study

J Am Heart Assoc. 2016 Sep 16;5(9):e003477. doi: 10.1161/JAHA.116.003477.

Abstract

Background: Cerebral microbleeds (CMBs) represent intracerebral hemorrhages due to amyloid angiopathy or exposure to modifiable risk factors. Few community-based stroke-free studies including blacks and Hispanics have been done.

Methods and results: The Northern Manhattan Study (NOMAS) is a stroke-free, racially and ethnically diverse cohort study. Brain MRI was performed in 1290 participants, 925 of whom had available T2* gradient-recall echo data. We used multivariable logistic regression to examine the association of sociodemographics, vascular risk factors, apolipoprotein E (APOE) genotype, and brain MRI markers with CMB presence and location. The prevalence of CMBs in our cohort was 5%. Of the 46 participants with CMBs, 37% had only deep CMBs, 48% had only lobar CMBs, and 15% had CMBs in both locations. The difference in CMB distribution was not statistically significant across race/ethnic group or APOE genotype. In multivariable analyses, age (OR [95% CI]: 1.09 [1.04, 1.15]) and SBIs (2.58 [1.01, 6.59]) were positively associated with CMB presence, and diabetes medication use was negatively associated (0.25 [0.07, 0.86]).

Conclusions: CMBs may represent the severity of vascular disease in this racially and ethnically diverse cohort. Larger studies are needed to elucidate the association between diabetes medication use and CMB presence.

Keywords: cerebral microbleed; magnetic resonance imaging; risk factor.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Alcohol Drinking / epidemiology
  • Anticholesteremic Agents / therapeutic use
  • Anticoagulants / therapeutic use
  • Antihypertensive Agents / therapeutic use
  • Apolipoproteins E / genetics
  • Black or African American / statistics & numerical data
  • Blood Glucose / metabolism
  • Blood Pressure
  • Body Mass Index
  • Cerebral Hemorrhage / diagnostic imaging
  • Cerebral Hemorrhage / epidemiology*
  • Cerebral Hemorrhage / ethnology
  • Cerebral Hemorrhage / genetics
  • Cholesterol, HDL / blood
  • Cholesterol, LDL / blood
  • Diabetes Mellitus / drug therapy
  • Diabetes Mellitus / epidemiology
  • Ethnicity / statistics & numerical data*
  • Exercise
  • Female
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Hypertension / drug therapy
  • Hypertension / epidemiology
  • Hypoglycemic Agents / therapeutic use
  • Logistic Models
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Multivariate Analysis
  • New York City / epidemiology
  • Odds Ratio
  • Platelet Aggregation Inhibitors / therapeutic use
  • Prospective Studies
  • Risk Factors
  • Smoking / epidemiology
  • Triglycerides / blood
  • White People / statistics & numerical data

Substances

  • Anticholesteremic Agents
  • Anticoagulants
  • Antihypertensive Agents
  • Apolipoproteins E
  • Blood Glucose
  • Cholesterol, HDL
  • Cholesterol, LDL
  • Hypoglycemic Agents
  • Platelet Aggregation Inhibitors
  • Triglycerides