Sigurdsson S, Aspelund T, Kjartansson O, et al. - Evaluation of risk-factors by location of asymptomatic infarcts detected on magnetic resonance imaging could enhance the ability to target as well as optimize preventive therapeutic approaches to avert stroke.

• Researches on the link of cerebrovascular risk factors to magnetic resonance imaging identified brain infarcts have been inconsistent, therefore, a hypothesis that risk-factors could vary based on where the infarct is located in subcortical-, cortical-, and cerebellar regions, was tested.

• From the longitudinal population-based AGES (Age, Gene/Environment Susceptibility)-Reykjavik Study, a total of 2,662 participants with mean age of 74.6±4.8 underwent brain magnetic resonance imaging at baseline and on average 5.2 years later.

• Prevalent subcortical infarcts were found to be linked with hypertension [PRR (risk-ratios of prevalent infarcts, 2.7], systolic blood pressure (PRR, 1.2), and diabetes (PRR, 2.8); incident subcortical infarcts were related to systolic [IRR (risk-ratios of incident infarcts), 1.2] and diastolic (IRR, 1.3) blood pressure.

• There was an association of prevalent and incident cortical infarcts with carotid plaques (PRR, 1.8 [95% CI, 1.3–2.5] and IRR, 1.9 [95% CI, 1.3–2.9], respectively), and atrial fibrillation was significantly related to prevalent cortical infarcts (PRR, 1.8 [95% CI, 1.2–2.7]).

• Following were revealed as risk-factors for prevalent cerebellar infarcts: hypertension (PRR, 2.45), carotid plaques (PRR, 1.45), and migraine with aura (PRR, 1.6).

• The only association of incident cerebellar infarcts was with any migraine (IRR, 1.4).

• Overall, risk for subcortical infarcts rose with small vessel disease risk-factors such as hypertension and diabetes.

• Risk for cortical infarcts and for cerebellar infarcts tends to increase with atherosclerotic/coronary processes and with a more mixed profile of factors, respectively.