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. 2014 Jan;45(1):255-7.
doi: 10.1161/STROKEAHA.113.003602. Epub 2013 Nov 7.

Effect of normal aging versus hypertension, abnormal body mass index, and diabetes mellitus on white matter hyperintensity volume

Kevin S King  1 , Ronald M Peshock, Heidi C Rossetti, Roderick W McColl, Colby R Ayers, Keith M Hulsey, Sandeep R Das
Affiliations

Effect of normal aging versus hypertension, abnormal body mass index, and diabetes mellitus on white matter hyperintensity volume

Kevin S King et al. Stroke. 2014 Jan.

Abstract

Background and purpose: The natural history of white matter hyperintensity (WMH) progression resulting from normal aging versus comorbid vascular insults remains unclear. Therefore we investigated age-related differences in WMH volumes among a group with comorbid hypertension, abnormal body mass index, and diabetes mellitus to a normal aging group drawn from the same population lacking any of these comorbidities.

Methods: WMH volumes were acquired using 3T MRI for 2011 Dallas Heart Study participants. The slope of the WMH versus age regression was compared between normal and comorbidity groups<50 and ≥50 years of age where a change in slope was demonstrated.

Results: Aging was linearly associated with greater log WMH volume for both normal (P=0.02) and comorbidity (P<0.0001) groups. Beyond 50 years of age, more rapid increases in WMH volumes for age were seen in the group with comorbidities (P<0.0001) but not in the normal group (P=0.173). The between-group difference in slope of expected WMH for age was significantly greater in the comorbidity groups≥50 years of age (P=0.0008) but not <50 years of age (P=0.752).

Conclusions: After 50 years of age, but not before, comorbid hypertension, obesity, and diabetes mellitus were associated with significantly larger WMH volumes for age compared with a normal aging group lacking these conditions. These results support the assertion that age-related differences in WMH volumes are significantly increased in the presence of comorbidities, but the effect is only detectable after 50 years of age.

Keywords: aging; white matter hyperintensity.

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Figures

Figure 1
Figure 1
WMH values for age among those with and without comorbid hypertension, abnormal BMI and diabetes. Participants with comorbidities are in light gray while those in a normal aging group without comorbidities are in dark gray. A significant threshold was seen at age 50 for the group with comorbidities, with greater log WMH volumes per year of age after this point.
See this image and copyright information in PMC

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