Evidence map›Paper›PMID 39557031›Full record

SynthesisCerebrovascular diseases (Basel, Switzerland)2025

The Impact of Vascular Risk Factors on Cerebral Amyloid Angiopathy: A Cohort Study in Hereditary Cerebral Amyloid Angiopathy and a Systemic Review in Sporadic Cerebral Amyloid Angiopathy.

Sabine Voigt, Sabine Voigt, Ingeborg Rasing, Maaike C van der Plas, Sarah J H Khidir, Emma A Koemans, Kanishk Kaushik, Ellis S van Etten, Jan W Schoones, Erik W van Zwet and 1 more

Abstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Cerebrovascular diseases (Basel, Switzerland), 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Cerebral amyloid angiopathy: a narrative review.Frontiers in aging neuroscience · 2025
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Sabine Voigt
Sabine VoigtDepartment of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
Ingeborg RasingDepartment of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
Maaike C van der PlasDepartment of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
Sarah J H KhidirDepartment of Rheumatology, Leiden University Medical Center, Leiden, The Netherlands.
Emma A KoemansDepartment of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
Kanishk KaushikDepartment of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
Ellis S van EttenDepartment of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
Jan W SchoonesDirectorate of Research Policy, Leiden University Medical Center, Leiden, The Netherlands.
Erik W van ZwetDepartment of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands.
Marieke J H WermerDepartment of Neurology, Leiden University Medical Center, Leiden, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

introductionCerebral amyloid angiopathy (CAA) has a remarkably variable disease course, even in monogenetic hereditary forms. Our aim was to investigate the prevalence of vascular risk factors and their effect on disease onset and course in Dutch-type hereditary (D-)CAA and sporadic CAA.

methodsWe performed a cohort study in D-CAA to investigate the association between vascular risk factors (hypertension, hypercholesterolemia, smoking, and alcohol use) and age of intracerebral hemorrhage (ICH) onset and time of ICH recurrence with survival analyses. In addition, we performed a systematic review to assess the prevalence of vascular risk factors and their effect on clinical outcome in sporadic CAA. We searched PubMed, Embase, Web of Science, and Cochrane Library from 1987 to 2022 and included cohorts with ≥10 patients. We created forest plots, calculated pooled estimates, and reported variability (heterogeneity plus sampling variability) and risk of bias.

resultsWe included 70 participants with D-CAA (47% women, mean age 53 years). Sixteen (23%) had hypertension, 15 (21%) had hypercholesterolemia, 45 (64%) were smokers, and 61 (87%) used alcohol. We found no clear effect of vascular risk factors on age of first ICH (log-rank test hypertension: p = 0.35, hypercholesterolemia: p = 0.41, smoking: p = 0.61, and alcohol use: p = 0.55) or time until ICH recurrence (log-rank test hypertension: p = 0.71, hypercholesterolemia: p = 0.20, and smoking: p = 0.71). We identified 25 out of 1,234 screened papers that assessed the prevalence of risk factors in CAA and 6 that reported clinical outcomes. The pooled prevalence estimates of hypertension was 62% (95% CI: 55-69%), diabetes was 17% (95% CI: 14-20%), dyslipidemia was 32% (95% CI: 23-41%), and tobacco use was 27% (95% CI: 18-36%). One study reported study diabetes and hypertension to be associated with a lower risk of recurrent ICH, whereas another study reported hypertension to be associated with an increased risk. All other studies showed no association between vascular risk factors and clinical outcome. High-quality studies focusing on vascular risk factors were lacking.

conclusionIn patients with D-CAA and sporadic CAA, the prevalence of vascular risk factors is high. Although this suggests an opportunity for prevention, there is no clear association between these risk factors and CAA-related ICH onset and recurrence.

Indexed as

Cerebral Amyloid AngiopathyCerebral Amyloid Angiopathy, FamilialCerebral HemorrhageHypercholesterolemiaHypertensionAdultAgedAge of OnsetAlcohol DrinkingFemaleHumansMaleMiddle AgedPrevalencePrognosisRecurrenceCerebral amyloid angiopathyIntracerebral hemorrhageRisk factorsSystematic review

Identifiers

PMID39557031
PMCPMC12500274

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.