| Abstract: | Objective:High blood pressure and low carotid flow are positively associated with acute cerebrovascular disease risk, such as stroke. However, the determinants of white matter hyper-intensity (WMHI) and its association with blood pressure and carotid flow remains unclear. The present study was conducted to investigate the determinants of WMHI in a general population and its associations with carotid flow and blood pressure.Design and method:A total 991 adults (>=50 yrs) from a community-based study, the I-Lan Longitudinal Aging Study, were evaluated for this study. Flow velocities at common and internal carotid artery (CCA and ICA), including peak systolic velocity (PSV) and end diastolic velocity (EDV), were measured by Doppler ultrasound. Systolic and diastolic blood pressure (SBP and DBP) were measured by an automatic oscillometric device. WMHI was measured by brain magnetic resonance imaging. General linear regression was used to evaluate the association between carotid flow, blood pressure, and WMHI.Results:The mean and median of WMHI were 2.20 and 0.857 cm3. SBP (r = 0.30), DBP (r = 0.21), CCA PSV (r = −0.21) and EDV (r = −0.38), and ICA PSV (r = −0.21) and EDV (−0.32) were significantly associated with log-WMHI (all p-values < 0.0001). In the multivariable linear regression model, age, SBP, CCA EDV, fasting blood sugar, and homocystein were independent predictors of WMHI. The WMHI in adults with SBP < 120, 120–129, 130–139, 140–159, and > = 160 were 1.30, 2.07, 2.28, 3.18 and 4.04 (cm3), respectively (p-value for trend < 0.001), and in adults with EDV < 16, 16–21 and > = 22 (cm/sec) were 4.58, 2.05, 0.98 (cm3), respectively (p-value for trend < 0.01). The positive association of systolic BP and negative association of EDV with WMHI remained significant in the model with controlling for age, gender, glucose, lipids, inflammatory status, drinking and smoking. The adults with SBP > = 160 mmHg plus EDV < 16 cm/sec had higher WMH volume (adjusted mean = 3.21 cm3, p-value < 0.001), compared to those with SBP < 120 plus EDV > = 22 cm/sec.Conclusions:High SBP and low CCA EDV were independently associated w |
