Abstract
Introduction: Carotid atherosclerosis may be associated with brain white matter hyperintensities (WMH). Few studies consider women at midlife, a critical time for women’s cardiovascular and brain health.We tested the hypothesis that higher carotid intima media thickness (IMT)would be associated with greaterWMHvolume(WMHV) among midlife women.We explored interactions by apolipoprotein E (APOE) ε4 status.
Methods:
Two hundred thirty-nine women aged 45 to 67 underwent carotid artery ultrasound, phlebotomy, andmagnetic resonance imaging (MRI). One hundred seventy participants had undergone an ultrasound 5 years earlier.
Results:
Higher IMT was associated with greater whole brain (B[standard error (SE)] = 0.77 [.31], P = 0.01; multivariable) and periventricular (B[SE] = 0.80 [.30], P = 0.008; multivariable) WMHV. Associations were observed for IMT assessed contemporaneously with the MRI and 5 years prior to the MRI. Associations were strongest for APOE ε4–positive women.
Discussion:
Among midlife women, higher IMT was associated with greater WMHV. Vascular risk is critical to midlife brain health, particularly forAPOEε4–positivewomen.