Brain Perivascular Spaces as Biomarkers of Vascular Risk: Results from the Northern Manhattan Study

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Fig 1.
Examples of parenchymal voids rated in the Northern Manhattan Study MR imaging substudy.

Table 1:

Hazard ratios between perivascular spaces and outcome events^{^a}

	All Deaths	Vascular Death	Myocardial Infarction	Any Stroke	Any Vascular Event
Small PVS score
Continuously	1.01, 0.98–1.04	1.06, 1.01–1.11	1.03, 0.98–1.08	1.04, 0.98–1.10	1.04, 1.01–1.07
Categorically
First tertile	Reference	Reference	Reference	Reference	Reference
Second tertile	0.72, 0.53–0.96	1.13, 0.68–1.87	2.21, 1.10–4.45	0.96, 0.54–1.72	1.23, 0.86–1.75
Third tertile	0.95, 0.71–1.27	1.34, 0.80–2.23	1.81, 0.89–3.71	1.51, 0.88–2.57	1.38, 0.97–1.98
Large PVS score
Continuously	0.99, 0.90–1.10	0.99, 0.89–1.10	1.10, 0.93–1.04	1.07, 0.88–1.28	1.08, 0.97–1.21
Categorically
≤1	Reference	Reference	Reference	Reference	Reference
≥2	1.02, 0.77–1.36	1.03, 0.77–1.67	1.40, 0.83–2.36	0.99, 0.60–1.61	1.07, 0.78–1.48

↵a Models are adjusted for head size, motion artifacts, age, sex, ethnicity, vascular risk factors at MRI and during follow-up (hypertension, hypercholesterolemia, diabetes, and smoking), prior cardiac disease, and body mass index. Data are hazard ratios and 95% CIs.

Table 2:

Risk of vascular events by anatomic location^{^a}

	All Deaths	Vascular Death	Myocardial Infarction	Any Stroke	Any Vascular Event
Small PVS score
Basal ganglia	1.01, 0.95–1.08	1.12, 1.02–1.22	1.06, 0.94–1.19	1.00, 0.90–1.12	1.06, 1.00–1.13
Subcortical	1.01, 0.95–1.07	1.06, 0.99–1.14	1.01, 0.94–1.12	1.08, 1.00–1.16	1.05, 0.99–1.14
Posterior fossa	1.02, 0.80–1.36	1.19, 0.79–1.76	1.26, 0.83–1.91	1.09, 0.70–1.67	1.09, 0.83–1.44
Large PVS score
Subcortical white matter	0.68, 0.43–1.07	0.81, 0.42–1.47	1.26, 0.85–1.85	1.32, 0.95–1.85	1.08, 0.79–1.47
Subinsular	0.94, 0.80–1.10	1.21, 0.92–1.39	1.10, 0.84–1.43	1.08, 0.80–1.45	1.11, 0.93–1.30
Basal ganglia supraputaminal	1.73, 1.07–2.77	0.54, 0.22–2.25	1.17, 0.31–4.37	1.45, 0.61–3.43	0.90, 0.40–1.91
Basal ganglia infraputaminal	1.05, 0.88–1.25	1.24, 0.93–1.66	0.98, 0.63–1.46	0.92, 0.70–1.22	1.09, 0.89–1.33

↵a Models are adjusted for head size, motion artifacts, age, sex, ethnicity, vascular risk factors at MRI and during follow-up (hypertension, hypercholesterolemia, diabetes, smoking), prior cardiac disease, and body mass index. Data are hazard ratios and 95% CIs.

Table 3:

Stratified risk model by tertiles of pulse pressure and systolic blood pressure^{^a}

Stratified by	Low Tertile	Middle Tertile	High Tertile
Pulse pressure at MRI
Small PVS score
Vascular death	1.07 (0.96–1.18)	1.05 (0.96–1.14)	1.08 (1.01–1.17)
Any stroke	1.01 (0.90–1.13)	1.03 (0.90–1.18)	1.07 (0.98–1.16)
Any vascular event	1.05 (0.98–1.13)	1.02 (0.96–1.09)	1.05 (0.99–1.10)
Systolic blood pressure at MRI
Small PVS score
Vascular death	1.08 (0.99–1.18)	0.96 (0.86–1.08)	1.11 (1.04–1.20)
Any stroke	1.05 (0.94–1.17)	0.95 (0.83–1.09)	1.08 (1.01–1.16)
Any vascular event	1.05 (0.98–1.12)	1.02 (0.95–1.09)	1.05 (1.00–1.11)

↵a Models are adjusted for head size, motion artifacts, age, sex, ethnicity, vascular risk factors at MRI and during follow-up (hypertension, hypercholesterolemia, diabetes, and smoking), prior cardiac disease, and body mass index. Data are hazard ratios and 95% CIs.

Table 4:

Stratified risk models by white matter hyperintensities volume tertiles^{^a}

Stratified by	WMH Low Tertile	WMH Middle Tertile	WMH High Tertile
Small PVS score
All deaths	Referent group	1.01 (1.97–1.05)	1.04 (1.01–1.07)
Vascular death		1.06 (1.00–1.11)	1.08 (1.04–1.12)
Any stroke		1.01 (0.94–1.08)	1.07 (1.02–1.12)
Any vascular event		1.03 (0.99–1.07)	1.05 (1.02–1.08)

↵a Models are adjusted for head size, motion artifacts, age, sex, ethnicity, vascular risk factors at MRI and during follow-up (hypertension, hypercholesterolemia, diabetes, and smoking), prior cardiac disease, and body mass index. Data are hazard ratios and 95% CIs.

Table 5:

Stratified risk models by models by LPI-SBI status^{^a}

↵a Models are adjusted for head size, motion artifacts, age, sex, ethnicity, vascular risk factors at MRI and during follow-up (hypertension, hypercholesterolemia, diabetes, and smoking), prior cardiac disease, and body mass index. Data are hazard ratios and 95% CIs.