Abstract 5823: Prevalence of Silent Cerebral Infarcts in Pre-Elderly With Hypertension in Japan
Introductions: Hypertension is a major risk factor for stroke, a leading cause of severe disability in elderly in Japan. Silent cerebral infarcts are also associated with clinical stroke and its early detection and treatment are emphasized in the stroke guidelines. However, the detection for silent cerebral infarcts before being elderly has been limited.
Hypothesis: We assessed the hypothesis that the pre-elderly with hypertension is a high-risk group for silent cerebral infarcts in Japan.
Methods: We established a population-based study which consisted of a probability sample of community-living persons who were pre-elderly between the ages of 50 and 65 with hypertension detected by regular medical check-ups of public health service in Otokuni district, Kyoto, Japan. All participants were subjected to brain magnetic resonance (MR) imaging as well as Mini Mental Status Examination (MMSE). The risk factors other than hypertension, including obesity, hyperlipidemia, diabetes, and exercise behaviour, were also obtained. MR imaging was carried out by the simplified method suited for group check-ups with T2-weighted images and MR angiography of 3-dimensions time-of flight. Each MR studies were evaluated by 3 radiologists. The data of Japanese national health survey matched on age and sex was used as a control.
Results: Over two year period, 441 pre-elderly with hypertension were registered. All participants were free from neurological symptoms as well as dementia, as determined by the results of MMSE scoring 25 and over. In spite of no clinical neurological signs, we detected abnormal findings in 78.9% of the 348 subjects, including silent cerebral infarcts in 49.4% (n=217), intracranial artery stenosis in 22.3% (n=98), cerebral aneurysm in 11.8% (n=52), and undetermined in 9.8% (n=43) of participants. These detection rates were significantly higher than those reported previously. Among the risk factors other than hypertension, only the obesity correlated to the incidence of silent cerebral infarcts.
Conclusions: In conclusion, the prevalence of silent cerebral infarcts is quite high in pre-elderly with hypertension. The results also indicate that this population can be a target for group medical check-ups for stroke prevention.