Article

Sex differences in the risk profile and male predominance in silent brain infarction in community-dwelling elderly subjects: the Sefuri brain MRI study

Center for Emotional and Behavioral Disorders, National Hospital Organization Hizen Psychiatric Center, Saga 842-0192, Japan.
Hypertension Research (Impact Factor: 2.94). 07/2010; 33(7):748-52. DOI: 10.1038/hr.2010.69
Source: PubMed

ABSTRACT Although brain infarction is more common in men, the male predominance of silent brain infarction (SBI) was inconsistent in the earlier studies. This study was to examine the relationship between sex differences in the risk profile and SBI. We conducted a population-based, cross-sectional analysis of cardiovascular risk factors and SBI on MRI. We asked all the female participants about the age at natural menopause and parity. SBI was detected in 77 (11.3%) of 680 participants (266 men and 414 women) with a mean age of 64.5 (range 40-93) years. In the logistic analysis, age (odds ratio (OR)=2.760/10 years, 95% confidence interval (CI)=2.037-3.738), hypertension (OR=3.465, 95% CI=1.991-6.031), alcohol intake (OR=2.494, 95% CI=1.392-4.466) and smoking (OR=2.302, 95% CI=1.161-4.565) were significant factors concerning SBI. Although SBI was more prevalent among men, this sex difference disappeared on the multivariate model after adjustment for other confounders. In 215 women aged 60 years or older, age at natural menopause, early menopause, duration of menopause, number of children and age at the last parity were not significantly associated with SBI after adjustment for age. Hypertension and age were considered to be the major risk factors for SBI in community-dwelling people. Male predominance in SBI was largely due to higher prevalence of alcohol habit and smoking in men than in women in our population.

0 Followers
 · 
153 Views
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: A synergistic effect of alcohol and hypertension has been suggested to increase the risk for stroke. However, the contribution of alcohol-induced hypertension to stroke morbidity and mortality may be greater than observed, because the effects of different drinking patterns have not been separately investigated. Alcohol-induced transient peaks in systolic blood pressure may predispose to stroke. Recent studies have measured time trends of blood pressure elevations in relation to alcohol consumption. They found a significant morning surge in blood pressure, which was related to alcohol intake in a dose-dependent manner and was independent of smoking. Men with a severe form of hypertension showed a 12-fold increased risk for cardiovascular disease mortality associated with heavy binge drinking. Binge drinking is a significant risk factor for stroke. Hypertensive patients should be warned about the risks of alcohol and urged to avoid binge drinking because of an increased risk for all subtypes of stroke.
    Current Hypertension Reports 02/2011; 13(3):208-13. DOI:10.1007/s11906-011-0194-y · 3.90 Impact Factor
  • Source
    [Show abstract] [Hide abstract]
    ABSTRACT: Although recent studies have found that chronic kidney disease (CKD) is an independent risk factor for cognitive impairment in population-based cohorts, the mechanisms of cognitive impairment in subjects with CKD are unclear. We examined 503 elderly subjects (mean age: 72.4 years), who were living independently at home without apparent dementia, using MRI. The subject was judged as having frontal lobe dysfunction if the scores on the modified Stroop test were higher than the fifth quintile for each given decade. Serum creatinine values, measured by the enzymatic method, were used for the Japanese equation of estimated glomerular filtration rate (eGFR). Subjects in the frontal lobe dysfunction group tended to have higher blood pressure, lower eGFR and more lacunar infarcts, and were less educated. When possible confounders were entered into the multivariate logistic regression model, the independent predictors of frontal lobe dysfunction were eGFR (odds ratio 0.854; 95% confidence interval (CI) 0.743-0.983 per 10 ml min(-1) per 1.73 m(2)) and the number of lacunar infarction (odds ratio 1.460; 95% CI 1.127-1.892). The mean of the logarithmically transformed Stroop test scores in the eGFR<60 ml min(-1) per 1.73 m(2) group was 1.376 (95% CI 1.301-1.451), which was significantly higher than that (1.250) for the eGFR 60-89 ml min(-1) per 1.73 m(2) group (95% CI 1.215-1.285) (P=0.009) and tended to be higher than that (1.264) for the eGFR ≥90 ml min(-1) per 1.73 m(2) group (95% CI 1.188-1.340) (analysis of covariance, adjusted for age). The present study showed that CKD and subclinical lacunar infarction independently contributed to frontal lobe dysfunction in healthy elderly subjects.
    Hypertension Research 06/2011; 34(9):1023-8. DOI:10.1038/hr.2011.83 · 2.94 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The aim of this hospital-based cohort study was to clarify the independent association between silent brain infarct (SBI) and arterial stiffness indicated by brachial-ankle pulse wave velocity (baPWV) including the cutoff value for SBI. We studied 240 consecutive patients (mean age 69 years) with no history of stroke. We assessed the presence of SBI, white matter hyperintensities (WMHs), and risk factors. Arterial stiffness was evaluated using baPWV. We measured the intima-media thickness of the common carotid artery (CCAIMT) using carotid ultrasonography. We divided patients into two groups according to the presence or absence of SBI, and compared clinical characteristics between the two groups. In multivariable analysis, increased baPWV [by 1 m/s; odds ratio (OR) 1.13, 95% confidence interval (CI) 1.02-1.25] was independently associated with SBI. The baPWV cutoff value for SBI was 17.49 m/s. Patients with baPWV≥17.49 m/s had a higher possibility of the presence of SBI (OR 2.30, 95% CI 1.02-5.34) compared with patients with baPWV <17.49 m/s. Furthermore, the adjusted OR for the presence of SBI of the combination of baPWV≥17.49 m/s and CCAIMT≥1.1 mm (OR 2.73, 95% CI 1.24-6.11) was higher compared with that of baPWV≥17.49 m/s (OR 2.47, 95% CI 1.11-5.65). Arterial stiffness is independently associated with SBI. Measurement of baPWV can indicate the presence of SBI, especially in patients with baPWV≥17.49 m/s.
    Internal Medicine 01/2012; 51(9):1003-8. DOI:10.2169/internalmedicine.51.6852 · 0.97 Impact Factor
Show more

Preview

Download
4 Downloads
Available from