Vascular risk factors like arterial hypertension influence stroke risk in the general population but do not provide information about the atherosclerotic process in individual subjects which crucially determine the occurrence of stroke events.

In the population-based Heinz Nixdorf Recall study which comprises more than 4800 subjects between 45 and 75 years, our research group prospectively analyses the association between cardiovascular risk factors, subclinical atherosclerosis and incident stroke events. 

In our previous analyses we have already shown that intima-media thickness of the common-carotid artery, ankle-brachial index and coronary artery calcification (Figure 1) independently predict stroke in addition the classical risk factors (like hypertension and diabetes) and that stroke prediction is further improved when these markers are combined.

Figure 1. Subclinical atherosclerosis markers. Analysis of intima-media thickness of the common-carotid artery by duplex sonography (left), analysis of the ankle-brachial index by standardized blood pressure measurement (middle) and analysis of coronary artery calcification by electron-beam computed tomography (right).

Publications

Gronewold J, Jokisch M, Schramm S, Jockwitz C, Miller T, Lehmann N, Moebus S, Jöckel KH, Erbel R, Caspers S, Hermann DM; Heinz Nixdorf Recall Study Investigative Group. Association of Blood Pressure, Its Treatment, and Treatment Efficacy With Volume of White Matter Hyperintensities in the Population-Based 1000BRAINS Study. Hypertension. 2021;78(5):1490-501.

Gronewold J, Kropp R, Lehmann N, Stang A, Mahabadi AA, Kälsch H, Weimar C, Dichgans M, Budde T, Moebus S, Jöckel KH, Erbel R, Hermann DM. Cardiovascular Risk and Atherosclerosis Progression in Hypertensive Persons Treated to Blood Pressure Targets. Hypertension. 2019;74(6):1436-47.

Gronewold J, Bauer M, Lehmann N, Mahabadi AA, Kälsch H, Weimar C, Berger K, Moebus S, Jöckel KH, Erbel R, Hermann DM; Heinz Nixdorf Recall Study Investigative Group. Coronary artery calcification, intima-media thickness, and ankle-brachial index are complementary stroke predictors. Stroke. 2014; 45(9):2702-9.

Janine Gronewold, PhD

Postdoc

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Anne-Carina Scharf, MD

Physician

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