Central arterial stiffening and intracranial atherosclerosis: the atherosclerosis risk in communities neurocognitive study (ARIC-NCS): Aortic stiffness & intracranial atherosclerosis

J Stroke Cerebrovasc Dis. 2024 Jan;33(1):107477. doi: 10.1016/j.jstrokecerebrovasdis.2023.107477. Epub 2023 Nov 15.

Abstract

Objectives: Previous studies suggest an association between central arterial stiffness (CAS) and intracranial atherosclerotic disease (ICAD) among Asian participants with stroke or hypertension; this association has not been evaluated in United States populations. We assessed the cross-sectional association of CAS with ICAD presence and burden in late-life, and differences in association by age, sex, and race.

Materials and methods: We conducted a cross-sectional analysis of 1,285 Atherosclerosis Risk in Communities Study participants [mean age 75 (standard deviation: 5) years, 38 % male, 20 % Black] at Visit 5 (2011-2013). CAS was measured as carotid-femoral pulse wave velocity (cfPWV) using the Omron VP-1000 Plus. ICAD was assessed using high-resolution vessel wall MRI and MR angiography. We evaluated associations of a 1 standard deviation (SD) cfPWV (3.02 m/s) and high vs. non-high cfPWV (≥ 13.57 m/s vs. < 13.57 m/s) with presence of plaques (yes/no) and plaque number (0, 1-2, and >2) using multivariable logistic and ordinal logistic regression models adjusted for covariates.

Results: Each one SD greater cfPWV was associated with higher odds of plaque presence (odds ratio (OR)=1.32, 95 % confidence interval (CI): 1.22, 1.43), and an incrementally higher odds of number of plaques (OR 1-2 vs. 0 plaques = 1.21, 95 % CI: 1.10, 1.33; OR >2 vs. 0 plaques = 1.51, 95 % CI: 1.33,1.71). Results suggested differences by race, with greater magnitude associations among Black participants.

Conclusions: CAS was positively associated with ICAD presence and burden; cfPWV may be a useful subclinical vascular measure for identification of individuals who are at high risk for cerebrovascular disease.

Keywords: Aortic stiffness; Arterial stiffness; Atherosclerosis; MRI; Pulse wave velocity.

MeSH terms

  • Aged
  • Atherosclerosis* / diagnostic imaging
  • Atherosclerosis* / epidemiology
  • Cross-Sectional Studies
  • Female
  • Humans
  • Intracranial Arteriosclerosis* / complications
  • Intracranial Arteriosclerosis* / diagnostic imaging
  • Intracranial Arteriosclerosis* / epidemiology
  • Male
  • Plaque, Atherosclerotic*
  • Pulse Wave Analysis / methods
  • Risk Factors
  • United States / epidemiology
  • Vascular Stiffness*