CEREBRAL WHITE MATTER LESIONS AND ATHEROSCLEROSIS IN THE ROTTERDAM STUDY

Cerebral white matter lesions (WML) seen on magnetic resonance imaging scans are associated with cardiovascular disease and vascular risk fa ctors. To assess the association between WML and atherosclerosis, we s tudied 111 people, aged 65 to 85 years, randomly sampled, and stratifi ed by age and sex, from participants in the Rotterdam Study. Cerebral T2-weighted magnetic resonance images in the axial plane were obtained for all subjects. Carotid atherosclerosis was ultrasonographically as sessed by the presence of stenosis, measurement of intima to media wal l thickness (IMT), and the presence of atherosclerotic plaques. A poss ible or definite myocardial infarction on an electrocardiogram was use d as an indicator of coronary atherosclerosis. The ankle to arm systol ic blood pressure ratio (ABI) was determined, and peripheral arterial disease was defined as an ABI lower than 0.90 in at least one side. Ca rotid atherosclerosis was significantly more pronounced in people with WML. The difference in common carotid IMT was 0.13 mm (95% confidence interval [CI] 0.04-0.21), whereas the odds ratio of WML associated wi th plaques in the carotid bifurcation was 3.9. The degree of internal carotid artery stenosis was not, however, associated with WML. The mea n ABI was significantly lower in people with WML than in those without lesions with a difference of -0.11 (95% CI -0.21 to -0.01). The odds ratio of WML associated with peripheral arterial disease and a possibl e or definite myocardial infarction was 2.4 and 3.1, respectively. We conclude that atherosclerosis, indicated by increased common carotid I MT, carotid plaques, and a lower ABI, is related to WML.