VASCULAR RISK-FACTORS AND ARTERIOSCLEROTIC DISEASE IN IDIOPATHIC NORMAL-PRESSURE HYDROCEPHALUS OF THE ELDERLY

Background and Purpose There is some evidence from previous studies th at idiopathic normal-pressure hydrocephalus (NPH) of the elderly might be linked to Vascular leukoencephalopathy. The purpose of this study was to examine the prevalence and impact of vascular risk factors and vascular diseases in idiopathic NPH compared with a control cohort. Me thods The prevalence of arterial hypertension; diabetes mellitus; hype rcholesterolemia; hyperlipidemia; smoking; obesity; and cardiac, cereb rovascular, and other arteriosclerotic diseases was assessed in 65 pat ients with idiopathic NPH. The findings were compared with those of 70 patients with comparable age distribution. To describe the difference s of the prevalences of vascular risk factors, odds ratios were obtain ed by univariate and multivariate analyses. Results The univariate ana lysis revealed significant associations between idiopathic NPH and art erial hypertension (prevalence, 54 of 65 [83%]; control group, 25 of 7 0 [36%]; P<.001) and diabetes mellitus (prevalence, 31 of 63 [49%]; co ntrol group, 20 of 70 [29%]; P<.015) hut not with other vascular risk factors. After multivariate regression analysis, only hypertension rem ained significantly associated with NPH (P<.0001). There was also a si gnificant association between NPH and cardiac (P<.001), cerebral arter iosclerotic (P=.007), and other arteriosclerotic diseases (P=.001). A positive association was found between the severity of clinical sympto ms of NPH and the presence of hypertension, especially for gait distur bance. The presence of hypertension was not related to the duration of NPW. Conclusions Our data show a highly significant association betwe en idiopathic NPH and arterial hypertension. Arterial hypertension mig ht be involved in the pathophysiological mechanisms promoting idiopath ic NPW.