Association between arterial stiffness and silent lacunes: insights from the Kailuan Cohort

Objective To investigate the association between arterial stiffness and silent lacunes. Methods An observational study based on the community population was conducted. The employees and retired employees of Kailuan group who participated in the 7th follow-up and completed brain magnetic resonance imaging (MRI) in 2020-2023 were selected as the subjects. According to the brachia-ankle pulse wave velocity (baPWV), the subjects were divided into non-arterial stiffness group (baPWV<14 m/s), mild arterial stiffness group (baPWV 14-<18 m/s) and severe arterial stiffness group (baPWV≥18 m/s). Brain MRI was used to detect the presence of silent lacunes. Multivariate logistic regression model and restrictive cubic spline were used to analyze the association between baPWV and the presence of silent lacunes. Results A total of 1 563 subjects were included, aged (54.5±11.6) years, 51.8% were male. There were 579 cases in non-arterial stiffness group, 686 cases in mild arterial stiffness group and 298 cases in severe arterial stiffness group. Silent lacunes were detected among 237 (15.2%) participants. After adjusting for potential confounding factors, logistic regression analysis showed that the odds ratio (OR) of silent lacunes increased with increasing baPWV (per stand deviation increase in baPWV, OR =1.26, 95%CI 1.03-1.54, P=0.024); and participants with severe arterial stiffness had a higher risk of having silent lacunes compared to those without arterial stiffness (OR=2.62, 95%CI 1.40-4.93, P=0.003). Restrictive cubic spline analysis showed that when baPWV was between 15 and <25 m/s, baPWV was positively correlated with the risk of silent lacunes. Conclusions There is a positive association and a dose-response relationship between baPWV and silent lacunes. The risk of silent lacunes is significantly higher in individuals with severe arterial stiffness compared to the population without arterial stiffness.