Association of Brain Volumes and White Matter Injury With Race, Ethnicity, and Cardiovascular Risk Factors: The Multi-Ethnic Study of Atherosclerosis

Thomas R. Austin, Ilya M. Nasrallah, Guray Erus, Lisa M. Desiderio, Lin Y. Chen, Philip Greenland, Barbara N. Harding, Timothy M. Hughes, Paul N. Jensen, W. T. Longstreth, Wendy S. Post, Steven J. Shea, Colleen M. Sitlani, Christos Davatzikos, Mohamad Habes, R. Nick Bryan, Susan R. Heckbert

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: Cardiovascular risk factors are associated with cognitive decline and dementia. Magnetic resonance imaging provides sensitive measurement of brain morphology and vascular brain injury. However, associations of risk factors with brain magnetic resonance imaging findings have largely been studied in White participants. We investigated associations of race, ethnicity, and cardiovascular risk factors with brain morphology and white matter (WM) injury in a diverse population. METHODS AND RESULTS: In the Multi-Ethnic Study of Atherosclerosis, measures were made in 2018 to 2019 of total brain volume, gray matter and WM volume, and WM injury, including WM hyperintensity volume and WM fractional anisotropy. We assessed cross-sectional associations of race and ethnicity and of cardiovascular risk factors with magnetic resonance imaging measures. Magnetic resonance imaging data were complete in 1036 participants; 25% Black, 15% Chinese-American, 19% Hispanic, and 41% White. Mean (SD) age was 72 (8) years and 53% were women. Although WM injury was greater in Black than in White participants in a minimally adjusted model, additional adjustment for cardiovascular risk factors and socioeconomic status each attenuated this association, rendering it nonsignificant. Overall, greater average WM hyperintensity volume was associated with older age and current smoking (69% greater vs never smoking); lower fractional anisotropy was additionally associated with higher diastolic blood pressure, use of antihypertensive medication, and diabetes. CONCLUSIONS: We found no statistically significant difference in measures of WM injury by race and ethnicity after adjustment for cardiovascular risk factors and socioeconomic status. In all racial and ethnic groups, older age, current smoking, hypertension, and diabetes were strongly associated with WM injury.

Original languageEnglish (US)
Article numbere023159
JournalJournal of the American Heart Association
Volume11
Issue number7
DOIs
StatePublished - Apr 5 2022

Bibliographical note

Funding Information:
This work was supported by the following: National Heart, Lung, and Blood Institute Contracts: 75N92020D00001, HHSN268201500003I, N01HC95159, 75N92020D00005, N01HC95160, 75N92020D00002, N01HC95161, 75N92020D00003, N01HC95162, 75N92020D00006, N01HC95163, 75N92020D00004, N01HC95164, 75N92020D00007, N01HC95165, N01HC95166, N01HC95167, N01HC95168 and N01HC95169, National Heart, Lung, and Blood Institute Grant: R01HL127659, National Center for Advancing Translational Sciences Grants: UL1TR000040, UL1TR001079, and UL1TR001420. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2022 The Authors.

Keywords

  • brain magnetic resonance imaging
  • cardiovascular risk factors
  • race and ethnicity
  • white matter injury

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