ArticleStroke2020
Microvascular Brain Disease Progression and Risk of Stroke: The ARIC Study.
Article in Stroke, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 1 of them a synthesis that pooled it.
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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.
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.
Who cites it
25 citing papers in PubMed, 1 synthesis or guideline pooled it, 31 citations in OpenAlex.
- Risks of stroke and myocardial infarction after retinal artery occlusion and their time dependence: a systematic review and meta-analysis.Journal of neurology · 2025Pooled it
- Diabetic cerebral microvascular disorder: from key pathologies to targeted interventions.Annals of medicine · 2026Review
- A Causal Association Study Between Brain Imaging Features and the Risk of Large Artery Atherosclerosis: A Two-sample Mendelian Randomization Study.Journal of molecular neuroscience : MN · 2026Article
- Heart-brain axis pathophysiological understanding and clinical impact.Frontiers in cardiovascular medicine · 2026Review
- Seeing the Small to Prevent the Big: The Role of Cerebral Microvessels in Ischemic Stroke Etiology and Prevention.Stroke research and treatment · 2026Review
- The risk factors of cerebral small vessel disease in patients with Systemic Lupus Erythematosus.BMC rheumatology · 2025Article
- Comprehensive genome-wide analysis of retinal vessel caliber reveals microvascular-blood pressure pathways: advancing predictive, preventive, and personalized medicine.The EPMA journal · 2025Article
- Blood pressure and the brain: the conundrum of hypertension and dementia.Cardiovascular research · 2025Review
- From Microcirculation to Aging-Related Diseases: A Focus on Endothelial SIRT1.Pharmaceuticals (Basel, Switzerland) · 2024Review
- Age-Related Risk of Stroke Following Ocular Motor Cranial Nerve Palsy.Journal of the American Heart Association · 2024Article
- Relationship of arterial stiffness and baseline vascular burden with new lacunes and microbleeds: A longitudinal cohort study.European stroke journal · 2024Article
- Association between cognitive impairment and risk of atrial fibrillation: The Atherosclerosis Risk in Communities study.Cardiology journal · 2024Article
- MDM2 Regulation of HIF Signaling Causes Microvascular Dysfunction in Hypertrophic Cardiomyopathy.Circulation · 2023Article
- Role of Vitamin D Deficiency in the Pathogenesis of Cardiovascular and Cerebrovascular Diseases.Nutrients · 2023Review
- Effect of hyperbaric oxygen combined with folic acid on clinical efficacy and cognitive function in patients with cerebral small vessel disease.American journal of translational research · 2023Article
- Cell non-autonomous regulation of cerebrovascular aging processes by the somatotropic axis.Frontiers in endocrinology · 2023Review
- Patterns of progression of cerebral small vessel disease markers in older adults of Amerindian ancestry: a population-based, longitudinal prospective cohort study.Aging clinical and experimental research · 2022Article
- Assessments of microvascular function in organ systems.American journal of physiology. Heart and circulatory physiology · 2022Review
- Association of Ischemic Stroke Incidence, Severity, and Recurrence With Dementia in the Atherosclerosis Risk in Communities Cohort Study.JAMA neurology · 2022Article
- Associations of ATP-Sensitive Potassium Channel's Gene Polymorphisms With Type 2 Diabetes and Related Cardiovascular Phenotypes.Frontiers in cardiovascular medicine · 2022Article
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Authors and funding
6 authors at 4 institutions in 2 countries.
Funding
Abstract
background and purposeData on the significance of combined white matter hyperintensities (WMH)/lacunar brain infarcts, and their progression over time for the prediction of stroke are scarce. We studied associations between the progression in combined measures of microvascular brain disease and risk of stroke in the ARIC study (Atherosclerosis Risk in Communities).
methodsProspective analysis of 907 stroke-free ARIC participants who underwent a brain magnetic resonance imaging (MRI) in 1993 to 1995, a second brain MRI in 2004 to 2006, and were subsequently followed for stroke incidence through December 31, 2017 (median [25%-75%] follow-up 12.6 [8.9-13.4] years). A combined measure of microvascular brain disease was defined at each visit and categorized by progression from first to second brain MRI as no progression; mild progression (increase of ≥1 unit in WMH grade or new lacune), and moderate progression (increase of ≥1 unit in WMH grade and new lacune). All definite/probable ischemic or hemorrhagic incident strokes occurring after this second MRI, and through 2017, were included. Associations between microvascular brain disease, progression in the combined measures, and stroke incidence were studied with Cox proportional hazard models, adjusting for age, sex, race, education level, time from first to second MRI, body mass index, smoking, hypertension, diabetes mellitus, and coronary heart disease.
resultsAt the second brain MRI (mean age 72), the distribution of the combined measure was 37% WMH grade <2 and no lacune; 57% WMH grade ≥2 or lacune; and 6% WMH grade ≥2 and lacune. No progression in the combined measures was observed in 38% of participants, 57% showed mild progression and 5% showed moderate progression. Sixty-four incident strokes occurred during the follow-up period. Compared with no change in the combined measure, moderate progression of microvascular brain disease was significantly associated with higher risk of stroke (adjusted hazard ratio, 3.00 [95% CI, 1.30-6.94]).
conclusionsProgression of microvascular brain disease, manifesting as both new lacunes and increase in WMHs grade, is related to substantial increase in long-term risk of stroke.
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Registered trials
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 Socratic graph.