ArticleJournal of the American Heart Association2025
Higher Burden of Cerebral Small Vessel Disease Is Associated With Risk of Incident Stroke in Community-Dwelling Individuals.
Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Antiplatelet Therapy for Stroke Prevention in Atherosclerotic Cardiovascular Disease-Naïve People with Cerebral Small-Vessel Disease: A Retrospective Cohort Study.Journal of clinical medicine · 2026Article
- Cognitive decline and risk of stroke in older women: a cohort study.BMC geriatrics · 2026Article
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9 authors.
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Abstract
backgroundMild manifestations of individual cerebral small vessel disease (CSVD) markers are common and may not denote increased risk, but high CSVD burden identifies individuals at increased risk of stroke and dementia. Scores incorporating multiple individual CSVD markers may better identify a person's risk. We related a multimarker CSVD score to risk of incident stroke and compared it with the Framingham Stroke Risk Profile (FSRP) in community-dwelling individuals.
methodsFramingham Heart Study participants aged ≥55 years, free of stroke and dementia, and with brain magnetic resonance imaging ratings of CSVD markers were included. A multimarker CSVD score reflecting increasing CSVD burden was used, assigning 1 point each for presence of cerebral microbleeds, severe perivascular spaces, extensive white matter hyperintensities, covert brain infarcts, and cortical superficial siderosis. Multivariable Cox proportional hazards regression analyses were used to relate CSVD score to incident stroke.
resultsAmong 1154 participants (46% men, mean age 70.9±8.7 years), 92 (8%) developed stroke over a median follow-up of 8.6 years (Q1-Q3: 5.1-12.5). In models adjusting for age, sex, time interval between clinic exam and magnetic resonance imaging, Framingham cohort, and FSRP, those with ≥3 markers had increased risk of stroke (hazard ratio [HR], 2.62 [95% CI, 1.17-5.88]). In comparison, a 5% increase in FSRP was also associated with increased risk (adjusted HR, 1.16 [95% CI, 1.04-1.29]). The FSRP and CSVD score had similar model discrimination metrics.
conclusionsHigher CSVD burden is associated with increased risk of stroke, beyond the effect explained by risk factors in the FSRP. These findings support consideration of CSVD burden to identify risk of stroke in community-dwelling individuals for early implementation of preventive strategies.
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