Cerebral Microbleeds, Vascular Risk Factors, and Magnetic Resonance Imaging Markers: The Northern Manhattan Study

Abstract

Background Cerebral microbleeds ( CMB s) represent intracerebral hemorrhages due to amyloid angiopathy or exposure to modifiable risk factors. Few community‐based stroke‐free studies including blacks and Hispanics have been done. Methods and Results The Northern Manhattan Study ( NOMAS ) is a stroke‐free, racially and ethnically diverse cohort study. Brain MRI was performed in 1290 participants, 925 of whom had available T2* gradient‐recall echo data. We used multivariable logistic regression to examine the association of sociodemographics, vascular risk factors, apolipoprotein E ( APOE ) genotype, and brain MRI markers with CMB presence and location. The prevalence of CMB s in our cohort was 5%. Of the 46 participants with CMB s, 37% had only deep CMB s, 48% had only lobar CMB s, and 15% had CMB s in both locations. The difference in CMB distribution was not statistically significant across race/ethnic group or APOE genotype. In multivariable analyses, age ( OR [95% CI ]: 1.09 [1.04, 1.15]) and SBI s (2.58 [1.01, 6.59]) were positively associated with CMB presence, and diabetes medication use was negatively associated (0.25 [0.07, 0.86]). Conclusions CMB s may represent the severity of vascular disease in this racially and ethnically diverse cohort. Larger studies are needed to elucidate the association between diabetes medication use and CMB presence.