Cardiovascular risk and preclinical atherosclerosis are associated with white matter hyperintensities in apparently healthy adults: the population-based cross-sectional study BIALYSTOK PLUS.

White matter hyperintensities, present in patients and asymptomatic individuals, have been previously shown to be associated with atherosclerosis risk factors like high blood pressure, hypercholesterolemia, smoking, and diabetes. To assess the associations between white matter hyperintensities volume and cardiovascular risk factors in a general apparently healthy population. The analysis includes 735 participants (age range 20 to 79) without neurological or severe cardiac diseases. The participants were subjected to detailed clinical examination, including medical history, biochemical analyses, carotid arteries ultrasound, and brain magnetic resonance imaging, followed by white matter hyperintensities segmentation using the Freesurfer tool. Participant were divided into three cardiovascular risk categories based on the 2021 European Society of Cardiology guidelines. The median volume of white matter hyperintensities was 95.2 mm3 (interquartile range 2.1 to 482.0 mm3). Multivariable analysis revealed positive, independent association between white matter hyperintensities volume and cardiovascular risk categories, glycated hemoglobin, presence of carotid plaques, and central systolic pressure. Analysis including people without hypertension or diabetes revealed mean intima-media thickness and high or very high cardiovascular risk class as independent predictors of white matter hyperintensities percentiles. The cardiovascular risk class, presence of carotid plaques, increased intima-media complex thickness and diabetes are the main risk factors for white matter hyperintensities in apparently healthy adults. People without hypertension or diabetes but with higher cardiovascular risk are also at risk of developing white matter hyperintensities, what emphasizes the value of assessment of the cardiovascular risk in the aspect of prediction of neurodegenerative changes.