Stroke risk profile predicts white matter hyperintensity volume: The Framingham study

Tom Jeerakathil, Philip A. Wolf, Alexa Beiser, Joseph Massaro, Sudha Seshadri, Ralph B. D'Agostino, Charles DeCarli

Research output: Contribution to journalArticlepeer-review

367 Scopus citations


Background and Purpose - Previous studies of cardiovascular risk factors and white matter hyperintensity (WMH) on brain MRI have been limited by the failure to exclude symptomatic cerebrovascular disease and dementia or by the use of semiquantitative rather than quantitative methods to measure WMH volume (WMHV). We examined the relationship between Framingham Stroke Risk Profile (FSRP) and WMHV measured quantitatively in a stroke and dementia-free subset of the Framingham Offspring Cohort. Methods - Brain MRI was performed in 1814 members of the Framingham Offspring Cohort. Pixel-based quantitative measures of WMHV corrected for head size were obtained using a semiautomated algorithm. WMHV was not normally distributed and therefore was log-transformed (LWMHV). The FSRP and its component risk factors measured a mean of 7.5 years before MRI were related to both continuous measures of LWMHV and to the presence of large volumes of LWMHV (LWMHV-large). All analyses were adjusted for age and sex. Results - FSRP was strongly associated with LWMHV and LWMHV-large. Age, smoking, history of cardiovascular disease, hypertension, and left ventricular hypertrophy by electrocardiogram were all significantly related to LWMHV or LWMHV-large. Conclusions - FSRP and several cardiovascular risk factors were related to both WMHV measured continuously and to a categorical designation of large volumes of WMH. These findings provide strong evidence of a vascular basis for WMH.

Original languageEnglish (US)
Pages (from-to)1857-1861
Number of pages5
Issue number8
StatePublished - Aug 2004
Externally publishedYes


  • Cerebrovascular disorders
  • Magnetic resonance imaging
  • Risk factors
  • White matter

ASJC Scopus subject areas

  • Clinical Neurology
  • Cardiology and Cardiovascular Medicine
  • Advanced and Specialized Nursing


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