Relationships of cerebral MRI findings to ultrasonographic carotid atherosclerosis in older adults - The cardiovascular health study

Cerebral magnetic resonance imaging (MRI) has demonstrated a high prevalenc e of infarct-like lesions, white matter hyperintensities, and evidence of c erebral atrophy in older adults. While these findings are generally believe d to be related to ischemia and atherosclerosis, their relationship to athe rosclerosis in the carotid arteries remains to be explored. Study subjects were part of the multicenter Cardiovascular Health Study, a cross-sectional study of 3502 women and men greater than or equal to 65 years of age under going cranial MRI and carotid ultrasonography. MRI infarcts were detected i n 1068 participants (29.3%) and measurable carotid plaque in 2745 (75.3%). MRI infarcts, ventricular and sulcal widening, and white matter score were strongly associated with carotid intimal-medial thickness (IMT) and stenosi s degree after adjustment for age and sex (all P < 0.01). Associations with plaque characteristics were less strong and less consistent; MRI infarcts were weakly associated only with surface irregularity, and ventricular size was weakly associated only with lesion density (both P < 0.04). In contras t, sulcal widening was strongly related to plaque characteristics, with sco res being higher in those with heterogeneous and irregular plaque (both P < 0.009). Adjustment for other risk factors, and for carotid IMT/stenosis, r emoved associations of MRI findings with plaque characteristics except for weak relationships remaining between MRI infarcts and surface irregularity and between sulcal score and heterogeneous plaque (both P < 0.03). MRI abno rmalities show strong and consistent relationships with increasing carotid IMT and stenosis degree but less strong associations with plaque characteri stics, especially after adjusting for IMT and stenosis.