White matter hyperintensity in middle-age adults (40–59 years) and risk factors for cerebrovascular disease

Introduction. White matter hyperintensity (WMH) is a neuroimaging age-related phenomenon associated with an increased cardiovascular risk in people with arterial hypertension (AH). The prevalence of WMH and its relationship with risk factors for cerebrovascular disease (CVD) in middle-age population requires clarification.

Aim: to assess the prevalence of the WMH phenomenon in people of working age (40–59 years) and to establish cerebrovascular risk factors associated with its development.

Material and methods. Study cohort (n = 376; 156 (41.5%) men and 220 (58.5%) women; mean age 49.7 ± 5.0 years) was formed by screening an open population (40–59 years of age). Using a questionnaire and clinical, laboratory and instrumental findings, including brain MRI (1T), the prevalence of cardiovascular and cerebrovascular risk factors was analyzed. The odds ratio (OR) of the event occurring and a 95% confidence interval were calculated.

Results. High prevalence of risk factors was revealed in the age group of 40–59 years, including AH in 46.7%, increased body mass index (BMI) in 60.6%, dyslipidemia (up to 39%), metabolic syndrome in 21.5%, thickening of the intima-media complex in 57.2%, atherosclerotic plaques in 49.7% of all cases. WMH was identified in 32% (120/376) of the subjects examined. An association between presence, severity of WMH and age, presence and severity of AH, as well as total burden of vascular risk factors was established. The most significant factors associated with the development of WMH in people aged 40–59 were found to be AH (OR 3.35), atherosclerosis of the brachiocephalic arteries (OR 1.79), and hyperglycemia (OR 1.36).

Conclusion. Thus, there is a high prevalence of risk factors for cardiovascular and cerebrovascular diseases in the working-age population of the megalopolis (Moscow) at the age of 40–59 years, which is associated with accelerated WMH formation. Significant factors that are associated with WMH are AH, atherosclerosis of the brachiocephalic arteries, hyperglycemia, as well as dyslipidemia and metabolic syndrome. Early detection and management of the listed modifiable risk factors are necessary to prevent the development and progression of cerebral injury.

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