Prospectively collected lifestyle and health information as risk factors for white matter hyperintensity volume in stroke patients

Eur J Epidemiol. 2019 Oct;34(10):957-965. doi: 10.1007/s10654-019-00546-x. Epub 2019 Aug 9.


Most studies of white matter hyperintensity volume (WMHV) in stroke patients lack reliable information on antecedent exposure to vascular risk factors. By leveraging prospective cohort data, we explored associations between lifestyle and health factors assessed 1 year prior to stroke and WMHV in individuals who experienced an ischemic stroke. This analysis was nested within two large prospective studies of initially healthy individuals. Information on lifestyle factors and health conditions was collected prior to the stroke event through annual or biannual questionnaires. For individuals who experienced their first confirmed ischemic stroke and had available magnetic resonance imaging, we measured WMHV using a validated semiautomated method. Linear regression was used to explore associations between lifestyle factors and health conditions and log-transformed WMHV. We measured WMHV in 345 participants with a first ischemic stroke event (mean age = 74.4 years; 24.9% male). After multivariate adjustment, history of diabetes was associated with decreased WMHV (p value = 0.06) while history of transient ischemic attack (p value = 0.09) and hypertension (p value = 0.07) were associated with increased WMHV. Most lifestyle factors and health conditions measured 1 year prior to stroke were not associated with WMHV measured at the time of ischemic stroke. Future studies could examine whether long term exposure to these factors impacts diffuse microvascular ischemic brain injury among stroke patients.

Keywords: Risk factors; Stroke; White matter hyperintensities.

MeSH terms

  • Aged
  • Female
  • Health Status*
  • Humans
  • Leukoencephalopathies / diagnosis*
  • Leukoencephalopathies / epidemiology
  • Life Style*
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged
  • Prospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Stroke / blood
  • Stroke / diagnostic imaging*
  • Stroke / epidemiology
  • Stroke / physiopathology
  • White Matter / diagnostic imaging*
  • White Matter / pathology