VASCULAR RISK-FACTORS, ATHEROSCLEROSIS, CEREBRAL WHITE-MATTER LESIONSAND CEREBRAL PERFUSION IN A POPULATION-BASED STUDY

We studied risk factors for cerebral vascular disease (blood pressure and hypertension, factor VIIc, factor VIIIc, fibrinogen), indicators o f atherosclerosis (intima-media thickness and plaques in the carotid a rtery) and cerebral white matter lesions in relation to regional cereb ral blood flow (rCBF) in 60 persons (aged 65-85 years) recruited from a population-based study. rCBF was assessed with single-photon emissio n tomography using technetium-99m d,l-hexamethylpropylene amine oxime (Tc-99m-HMPAO). Statistical analysis was performed with multiple linea r regression with adjustment for age, sex and ventricle-to-brain ratio . A significant positive association was found between systolic and di astolic blood pressure and temporo-parietal rCBF. In analysis with qua rtiles of the distribution, we found a threshold effect for the relati on of low diastolic blood pressure (less than or equal to 60 mmHg) and low temporo-parietal rCBF, Levels of plasma fibrinogen were inversely related to parietal rCBF with a threshold effect of high fibrinogen l evels (> 3.2 g/l) and low rCBF. Increased atherosclerosis was related to low rCBF in all cortical regions, but these associations were not s ignificant. No consistent relation was observed between severity of ce rebral white matter lesions and rCBF. Our results may have implication s for blood pressure control in the elderly population.